We put Adderall in F tier for depression: what people feel on it is an intoxicant effect, a burst of euphoria and energy that they build tolerance to. Amphetamines are a little more rewarding than methylphenidate, with higher abuse potential, and the tidy rule that methylphenidate suits children and amphetamines suit adults is far too simple.
For depression
What you feel on a stimulant (meth, cocaine or speed, which is what Adderall is) is an intoxicant effect: the euphoria and energy burst, and you build tolerance to that.
“What you feel on a stim, on meth or cocaine or speed, which is what Adderall is, is an intoxicant effect. That is the euphoria and energy burst, and you will build tolerance to that”
3:22Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDDMay 2026
Compared with methylphenidate
Amphetamines are a little more rewarding and have higher abuse potential. In many of the other conditions that bring adults in asking about ADHD, people know they have a problem and cling to ADHD as the name for it.
“we know that amphetamines are just a little bit more rewarding, have higher abuse potential. And a lot of those conditions that you that you were naming that, you know, people are They know they have a problem and they cling to ADHD”
40:55ADHD Again, But Juicier: Unpacking Misdiagnosis, Medication Overuse, and Cultural TrendsOct 2024 We psychiatrists cling to little factoids because we want to feel like we know something, and it is obviously infinitely more complex than that.
“I feel like as psychiatrists, we cling to those little factoids because we want to feel like we know something. And so it's like, oh, that's a thing to know. And it's obviously just infinitely more complex than that”
39:12ADHD Again, But Juicier: Unpacking Misdiagnosis, Medication Overuse, and Cultural TrendsOct 2024
It also comes up on
- ADHDSay why: you know they could get Adderall elsewhere, but you are worried about them, and stimulants are not a medication anyone can safely take. You would rather find out what this is.
- StimulantsSay why you are holding back: I know you can get Adderall elsewhere, but I'm worried about you. It may help today and tomorrow, but these things have consequences.
- ADHDIt is easy to medicalize a social problem. Pushing someone through a life that does not suit them on amphetamine, at the cost of their health, is a detriment to their life.
- OverdiagnosisHiding a life problem behind a medical diagnosis, and having someone push through it on what is essentially amphetamine at the cost of their physical and mental health, is a detriment to their overall life.
From these episodes
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.