bvbvbvbvbvbvbvbvbvbvbv

Karma: 190

bvbvbvbvbvbvbvbvbvbvbv 31 Jul 2026 13:47 UTC
1 point
0
in reply to: Shubhorup Biswas’s comment on: Adderall Tolerance: Much More Than You Wanted To Know
In cases were tolerance arises, it’s AFAIK not “increase dosage by 20%” but rather “even multiplying the dose by 4 makes suddenly no effect”.

Besides, it’s not a good weight loss drugs, except for people whose weight is caused by ADHD (higher risk of sugar addiction if untreated or something).

Lastly, dose effect relationships are not really correlated to weight in psychostimulants AFAIK.

bvbvbvbvbvbvbvbvbvbvbv 31 Jul 2026 6:00 UTC
3 points
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in reply to: Lukas Finnveden’s comment on: Adderall Tolerance: Much More Than You Wanted To Know
I wouldn’t say I’ve prescribed it to a lot, but i’ve talked about this with a lot of more senior doctors than me.

Those doc that talk about tolerance are either just talking from a theoretical risk (as in they never saw it), and when they talk from experience they never thought of checking the above factors I mentionned.

The thing is this tolerance idea is so ingrained in France that they’re ready to stop prescribing at the very first sign of a loss of effect without further investigation so we can’t even know. We are historically very underprescribers of methylphenidate because of psychoanalysis and amphetamines are available since only like 2 years and still out of pocket.

I do have other arguments to support my convinction that tolerance is that rare but am not comfortable sharing them here out in the open as they relate to my own chemistry. I could be biased sure, but let’s say I’m much more convincing when I mention those other points.

Edit: i also advised about 5 friends about their ADHD medication, they all take it daily without tolerance. And all doctors I know that are treated for ADHD take their meds daily and without holiday breaks.

bvbvbvbvbvbvbvbvbvbvbv 30 Jul 2026 7:29 UTC
9 points
1
in reply to: Lukas Finnveden’s comment on: Adderall Tolerance: Much More Than You Wanted To Know
Apologies for not being clearer and thanks for the opportunity to clarify.

Tolerance is something you hear about so often but see so rarely that it’s not something I take into account at work. If a patient tells me they’re experiencing loss of effect my approach is to triple check everything else. For example off the top of my head:
- Have they changed their diet? Methylphenidate is absorbed much more if taken with lipids but also delayed, and amphetamines are excreted much faster depending on the kidney acidity output. Likewise exercise impacts amphetamine duration. Maybe they’ve eaten ~~organic chemistry~~ fruits that wreak havoc on cytochromes. Maybe they finally stop coffee but didn’t tell you. Those things are not subtle and have a double digit percentage impact on pharmakinetic characteristics.
- Have they changed sleep patterns? Methylphenidate works less effectively when sleep deprived while amphetamines seem much better at hiding sleep deprivation feelings, also meaning it can get pretty chronic.
- Change of mood? Depression is so common that anhedonia alone is much more likely than tolerance.
- Wrong diagnostic? Bipolar and we changed season?
- Menstruation? They might have gone vegan and went anemic.
- Maybe their pharmacist changed the pill with an unbranded one? They have woefully different tail ends for OROS delivery vs unbranded ones (they have to guarantee the same area under the curve within 25% but there’s no requirements on tail or spikiness IIRC)
And of course patients are not reliable for figuring this out on their own and it takes quite a bit of time to lower the uncertainties on those question (but doc, what’s a lipid?). Especially patients suffering from ADHD.

Let me know if I can clarify this or other stuff or criticism.

bvbvbvbvbvbvbvbvbvbvbv 29 Jul 2026 16:36 UTC
2 points
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on: Adderall Tolerance: Much More Than You Wanted To Know
Hi, psychiatry resident here.

I got quite interested in ADHD and its therapeutics. I concluded that tolerance is basically not a thing most of the time and should not be really taken into account. To the point that when prescribing it I tend to say it even is a thing otherwise people take their medication too sparsely and end up missing a large portion of the benefits. I indeed think there are compounding effects to have your cognitive circuits “cured” by meds for long chunks of time rather than on and off. Tolerance to euphoric effects though seems to be a thing but it’s not something we encounter in therapeutic contexts.

I also worked in a unit specialized in pain managements. We basically went to other units to adjust pain killer prescriptions because other doctors always underdosed them unecessarily. We also spent a lot of time dispelling myths about tolerance. What I gather from my time there is that tolerance is rare and unpredictable, people have been prescribed literal grams per day of morphine (!) for years without issues nor increase of dosage, then for some patients someday for no known reason a drastic tolerance appeared. We switched to another related opioid and it worked directly at a regular dosage.

Cross tolerance too does not seem to be a thing in therapeutic contexts and switching from methylphenidate to amphetamines and back is apparently a working strategy in case of tolerance.

bvbvbvbvbvbvbvbvbvbvbv 8 Apr 2026 7:33 UTC
1 point
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on: How much faster is speaking, compared to typing on laptop vs phone vs writing?
I’m a medical resistent (psychiatrist) who is fairly innovative in terms of using STT technologies to get administrative work done (not trivial to do without compromising on privacy and to get working on locked down workstations).

I did notice that although STT allows a higher letter transfer rate, typing with my fingers is sufficiently slow relative to my thinking speed that I’m able to compress information in my head as I type it.

Hence the letter transfer rate is low but the data transfer rate is comparable if not higher.

Might be due to lack of training. Also to note: I’m a fast typer relative to my colleagues.

bvbvbvbvbvbvbvbvbvbvbv 8 Apr 2026 6:17 UTC
1 point
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in reply to: jefftk’s comment on: Chicken-Free Egg Whites
Amazon does not ship it in France. I stumbled upon this candidate though: https://www.koro.fr/substitut-d-oeuf-vegan-1-kg

bvbvbvbvbvbvbvbvbvbvbv 7 Apr 2026 19:04 UTC
1 point
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in reply to: jefftk’s comment on: Chicken-Free Egg Whites
Addendum: actually, taste aside, texture can be important. Can you comment on the kind of texture one could get to add some water to this powder? I find it hard to estimate the texture one could get by creating such pastes.

bvbvbvbvbvbvbvbvbvbvbv 7 Apr 2026 19:02 UTC
1 point
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in reply to: jefftk’s comment on: Chicken-Free Egg Whites
Good points. Thank you.

Indeed it really depends on if this powder has egg like flavor or not. If not, no point in adding it to pasts. But if yes: it might be an interesting way to veganise some dishes.

bvbvbvbvbvbvbvbvbvbvbv 7 Apr 2026 7:01 UTC
1 point
0
on: Chicken-Free Egg Whites
By any chance, do you know if we can use this powder to create some kind of omelets? I’m thinking something like: add water to the powder, stir it to make a paste, put it in a frying pan.

Similarly, any comment on adding the powder to some cooked pastas or rice?

bvbvbvbvbvbvbvbvbvbvbv 11 Feb 2026 9:46 UTC
2 points
0
on: Playing with an Infrared Camera
I can attest to the usefulness of infrared cameras.

I didn’t want to rely on “do I have a usb-c phone in 15 years” so opted for a handheld model called “Mastfui FY12″.

Very happy with it. I was able to figure out many things about the insulation of the building I live in. Many coldspots easy to fix. So I’m now lending it to all my friends to help them reduce the wasted heat in their home.

bvbvbvbvbvbvbvbvbvbvbv 1 Feb 2026 6:39 UTC
12 points
2
on: Basics of How Not to Die
I think I’d add: ask any medical doctor friend (or AI) to review the medication you take in a year. It can reveal bad habits like taking NSAID for bad reasons. Some people take them for any kind of pain and it can really flare up infections to a deadly point.

Not sure it fits in here but it came to my mind.

bvbvbvbvbvbvbvbvbvbvbv 21 Jan 2026 12:15 UTC
3 points
0
on: How to Use Foam Earplugs Correctly
Also, I suspect the makers use some kind of water soluble molecule that contribute to its mechanical properties. This ensures that they are disposable because as soon as you wash them with water they lose a lot of their mechanics. I recommend making them last as long as you’re feeling comfortable without washing, then using friction from some cloth or tissue paper to wipe its surface instead of soaking it. When you finally wash them, cold water and no soap.

The most effective ones for me have always been the MOLDEX—Pura Fit 7700. They can be bought in bulk too.

Also, your username is quite fitting for this topic.

bvbvbvbvbvbvbvbvbvbvbv 11 Oct 2024 21:34 UTC
4 points
0
on: How much I’m paying for AI productivity software (and the future of AI use)
Sharing my setup too:

Personnaly I’m just self hosting a bunch of stuff:
- litellm proxy, to connect to any llm provider
- langfuse for observability
- faster whisper server, the v3 turbo ctranslate2 versions takes 900mb of vram and are about 10 times faster than I speak
- open-webui, as it’s connected to litellm and ollama, i avoid provider lock in and keep all my messages on my backend instead of having some at openai, some at anthropic, etc. Additionally it supports artifacts and a bunch of other nice features. It also allows me to craft my perfecr prompts. And to jailbreak when needed.
- piper for now for tts but plan on switching to a selfhosted fish audio.
- for extra privacy I have a bunch of ollama models too. Mistral Nemo seems to be quite capable. Otherwise a few llama3, qwen2 etc.
- for embeddings either bge-m3 or some self hosted jina.ai models.
I made a bunch of scripts to pipe my microphone / speaker / clipboard / llms together for productivity. For example I press 4 times on shift, speak, then shift again, and voila what I said was turned into an anki flashcard.

As providers, I mostly rely on openrouter.ai which allows to swap between providers without issue. These last few months I’ve been using sonnet 3.5 but change as soon as there’s a new frontier model.

For interacting with codebases I use aider.

So at the end all my cost comes from API calls and none from subscriptions.

bvbvbvbvbvbvbvbvbvbvbv 5 Sep 2024 15:16 UTC
1 point
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on: What Depression Is Like
Very interesting of you to think of it that way. It turns out that it’s very in line with recent results from computation psychiatry. Basically in depression we can study and distinguish how much the lack of activity is due to “lack of ressource to act” vs “increased cost of action”. Both look clinically about the same but underlying biochemical pathways differ, so it’s a (IMHO) promising approach to shorten the times it takes for a doctor to find the appropriate treatment for a given patient.

If that’s something you already know I’m sorry, I’m short on time and wanted this to be out :)

bvbvbvbvbvbvbvbvbvbvbv 19 Aug 2024 8:00 UTC
2 points
0
on: Why you should be using a retinoid
Just a detail : Haven’t retinoids been discovered when looking for cancer treatments? I thought it was the origin story behind isotretinoin.

bvbvbvbvbvbvbvbvbvbvbv 31 Jan 2024 18:47 UTC
1 point
0
on: Notice when you stop reading right before you understand
My personnal solution to this is to mostly use Anki for everything and anything.
1. It helps not loose my momentum: if I see my cards about the beginning of the articles about transformers it increases my chance of finishing the article
2. It garuantees that I never get the dreaded my knowledge is limited to a couple of related keywords ("self-attention", "encoder"/"decoder") with no real gears-level understanding of anything. feeling. Making it all the more easier to get back to reading.
In fact I hate the number 2 feeling so much that it was a huge motivation to really master Anki. (1300 day streak or so with no sign of regret whatsoever)

bvbvbvbvbvbvbvbvbvbvbv 31 Jan 2024 8:22 UTC
4 points
0
on: Clip keys together with tiny carabiners
I think very cheap carabiners are extremely fragile especially for repeated use. I saw a failing mode where the mobile axis just opens in the wrong way by going around the stator. Keep that in kind when choosing which carabiner to use.

Might be better to keep using ring keyholders but have one decently strong carabineer to hold the rings together instead of what you did : tiny carabiners that hols onto a ring no?

bvbvbvbvbvbvbvbvbvbvbv 10 Jan 2024 7:33 UTC
1 point
0
on: Terminology: <something>-ware for ML?
I don’t really like any of those ideas. I think it’s really interesting that aware is so related though. I think the best bet would be based on software. So something like deepsoftware, nextsoftware, nextgenerationsoftware, enhancedsoftware, etc.

bvbvbvbvbvbvbvbvbvbvbv 8 Jan 2024 13:02 UTC
2 points
0
in reply to: Lech Mazur’s comment on: The Sequences on YouTube
For ayone trying to keep up with AI for film making, I recommend the youtube channel curious refuge https://www.youtube.com/channel/UClnFtyUEaxQOCd1s5NKYGFA

bvbvbvbvbvbvbvbvbvbvbv 5 Jan 2024 16:15 UTC
4 points
0
in reply to: jefftk’s comment on: Screen-supported Portable Monitor
Also, velcro comes in many strength and sizes. I find heavy duty velcros to be frequently underused in such DIY projects