1) Dear Alice,

I have a large amount of course work, which is combined with a job and extra-curriculars, and while I want to succeed in all of them, I find that I simply don't have enough time, even though I currently sleep only 4 or 5 hours a night. I mentioned this to a group of my friends here at school, and it turns out they all take stimulants to help them manage jam-packed undergraduate life. The pills are called ADDERALL and PROVIGIL. I have acquired some for myself, but before I take them, could you tell me if either has serious health risks? I do not have any other health problems or take any other medications. A few of my friends tell me that they sometimes stay awake for as long as 3 or 4 days. If it is reasonably safe, that would be great! Thank you.

Sincerely,
No time for sleep

2) Dear Alice,

Given the fact that this is a top-notch school, it's total hoo-ha that you haven't included any info on all the non-hard core, but still illegal, "study stimulants." Is all this ADDERALL gonna do me permanent damage or what?

awaiting your response,
awake

Dear No time for sleep and awake,

Juggling academics, jobs, extracurricular activities, a social life, and other responsibilities may be challenging and even impossible at times for many students. So, it makes sense that many are curious about substances that supposedly allow someone to manage all of these priorities more easily. Some people may try prescription stimulant drugs (like Adderall and Provigil) in the hope of boosting their alertness, concentration, attention, and memory. While some folks may claim that these sorts of drugs can power them through all-nighters, these drugs come with quite a few serious risks and are illegal to take without a health care provider's prescription and supervision. Furthermore, while people could perceive these medications as "helping" them academically, current research suggests otherwise. But fear not, there are plenty of ways to manage and prioritize commitments. But first, it might help to talk a bit about the uses and risks of the prescription medications you both mentioned.

Adderall, or amphetamine-dextroamphetamine, is used to treat the sleep disorder narcolepsy, as well as attention-deficit disorder with hyperactivity (ADHD). While helpful when used as prescribed, folks may develop physical and psychological dependence and stopping use could lead to withdrawal. Additionally, it can cause some side effects including anxiety or depression, increased heart rate, insomnia, dizziness, and diarrhea or constipation. Amphetamine-dextroamphetamine can also cause more serious side effects like irregular heartbeat, increased blood pressure, seizures, and hallucinations. If you experience any of these, it's recommended that you see a health care provider immediately.

Similarly, Provigil (also called modafinil) is used to treat people with sleep disorders and can be habit-forming. Modafinil's more common side effects can include headaches, nausea, and insomnia. It also has some serious and uncommon side effects including allergic reactions, extremely low or high blood pressure, and breathing problems. Finally, it's not recommended for folks who have heart problems, high blood pressure, and a history of mental illness, kidney disease, or liver disease.

These drugs affect people differently, they can interact with other medications in a variety of ways (too many to list here, in fact), and the potential for overdose is a concern. Long story short, it's recommended you avoid using stimulant drugs unless they’re prescribed and monitored by a health care provider. Hop on over to Prescription Stimulant Medications from the National Institute on Drug Abuse to learn more about them.

So, can these drugs help you academically? When combined with behavioral therapy, stimulant drugs have been shown to improve academic performance for those with ADHD, but there's solid research demonstrating that using these drugs doesn’t really help individuals who aren't diagnosed with ADHD. These substances don't improve learning and in some studies, students using them didn't see any improvement in grades and grade point average. In fact, for some people, these medications may slow down their thinking processes, thus leading to cognitive impairment rather than enhancement. For others, studies show that the placebo effect skews their perception of their own performance. For example, in thinking that they’d received a stimulant drug (but actually receiving the placebo), study participants believed they performed better on tests — their results indicated they hadn’t. Lastly, long-term effects are another key consideration — several studies have shown that misuse of prescription stimulant drugs is associated with lower educational attainment overall.

In light of these findings, it may be helpful to keep in mind all the non-chemical resources available to help handle the flood of commitments that accompany student life. One of the keys to effective time management is prioritizing and assessing the quality of your responsibilities, commitments, and activities — which can include saying no. Despite the high-achieving culture at many universities, it's possible to make choices to drop some of your commitments to get enough sleep and better manage various responsibilities. Managing stress in effective and healthy ways (getting enough quality sleep, eating balanced meals, and being physically active, for example) can prevent stress from negatively affecting your brain processes, including forming and retrieving memories.

If you’re still feeling overwhelmed, consider reaching out to friends, family, academic advisors, health promotion professionals, and mental health professionals for help with stress management techniques and to your balance your schedule. For more information on time management and stress relief tips, take a look at the related questions and Stress & Anxiety in the Go Ask Alice! archives.

Alice!

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