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wedrifid comments on Akrasia Tactics Review - Less Wrong
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I have no sources, but if modafinil was actually effective for moderate-severe ADHD the drug company probably would have tried to get it approved to treat ADHD. They must have run at least some studies to determine that FDA approval for ADHD treatment was not going to happen.
Anecdotally, I believe that most psychiatrists only try modafanil for relatively mild ADHD in adults and usually only if the drug is requested by the patient.
My intuition on this is because amphetamine is just a much, much stronger drug than modafanil.
They are different types of drugs, sure. The most likely way for my comment to not be true is if ata stopped taking amphetamine not because it was ineffective, but because of the side effect profile. Modafanil does have a milder side effect profile. Failing that, modafanil would only probably really work for severe ADHD if it fixes a specific brain defect -- possible, but it seems unlikely.
Edit: This claims that the FDA rejection for modafanil was because of a single very adverse reaction of the frequently lethal Steven Johnsons Syndrome, where the diagnosis was later recanted. Not sure if that is the whole truth, but it means my premise is somewhat less likely based on the evidence. My intuition still holds. http://www.modafinil.com/
How does the lesswrong crowd feel about these recent stories? Having grown up in Europe I've always found the North American faith in treating psychological conditions with drugs a bit odd, I feel vindicated reading stories like this but I wonder if it is just cultural bias?
Have I got the right link there? The post I found was just a reference to the difficulty of properly accounting for the placebo effect when drugs have obvious side effect profiles.
On that tangent active placebos can be fascinating. For example, studies investigating the effect of psyclobin which use ritalin as an active placebo (to match the euphoria experience).
Robin Hanson expands on the story a bit. My general impression is that the US has adopted a number of drugs which are worse on most dimensions than those that are deemed illegal partly due to a crappy system for approving chemicals.
I think the placebo effect is pretty interesting. I also think the powerful effect of many illegal psychoactive substances is pretty interesting. I find it unfortunate that the FDA has such a powerful role in deciding what constitutes legitimate investigation of either.
I'm not going to argue and say that the FDA system is good; but I'm happy that with a system as deeply flawed as the FDA that more deadly drugs don't hit the market. Sure, lots of people die because there are working unapproved illegal treatments, but out of all of the unfortunate US government institutions, the FDA is not the worst.