The neurotypical response to speed (amphetamine) is still confusing me.

So the base mechanism is the same for everyone: amphetamine (alpha methyl phenethylamine) is a monoamine releasing agent. It displaces the monoamine neurotransmitters dopamine (3, 4 dihydroxy phenethylamine) and noradrenaline (beta hydroxy 3, 4 dihydroxy phenethylamine - these are all really similar molecules) from the synapses, forcing them to circulate. It then acts as a reuptake inhibitor for both, and weakly agonises both.

So suddenly lots of dopamine and noradrenaline available. Right. Simple enough. That's how it treats ADHD, a condition marked by pathologically low circulation of both to the point that certain neural activity that's supposed to happen ... doesn't.

Now noradrenaline controls alertness, and too much in the peripheral nervous system cab cause tachycardia and anxiety. This is why we titrate up. The peripheral nervous system gets tolerant to it but the therapeutic effects in the central nervous system continue.

Dopamine is the interesting one here. It does lots of things, including acing as a neural "damper" (which is why we're hyperactive), but more significantly it controls the human motivation system. If something is worth doing, completion of that something is marked by a release of dopamine. This tends to be muted or doesn't happen in ADHD which is why emptying the dishwasher feels like a five thousand mile deathmarch across broken glass.

But you add amphetamine and circulating dopamine increases, which starts the reward system functioning.

Here's where I get confused. Keep going, and you spam the system with dopamine.

Which means you don't NEED to do anything to get the "reward".

Which is why, when my meds are peaking, I can occasionally just sit there and stare into space, feeling perfectly content. Keep going and I'll fall asleep.

In a neurotypical it will also flood the CNS with dopamine.

So why do they then get wired when they too are getting constantly rewarded for doing literally nothing?

IDGI