Amphetamine Induced Psychosis | ADHD | Episode 22
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- Опубліковано 13 лис 2020
- Experts often dismiss amphetamine Induced psychosis as being rare, but it remains one of the most dangerous potential side effects of stimulant medications.
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My son is experiencing this. He is in a current crisis and delusional and angry. Thanks for sharing this. Praying for his recovery.
thought you were my mum for a sec
I went through this- it may take up to 3 weeks to get him back to normal but he WILL get back to normal. I can’t imagine what this is like on the other side of this but be gentle with him
Adderall EX was prescribed to my teen son for ADD (no prior substance use). Two weeks later he started having hallucinations. It wasnt until a month in that we truly realzed what was going on and discontinued the medication (it was a low dose).Two months later, it still has not stopped. They can last from a second to 45 minutes, and often one per day, auditory or visual, and occasionally delusional. After the episode, he is very much himself, and can identify what he went through was a hallucination. It has been life altering. It is horrifying to me that it was never offered as a warning that Adderall can induce persistent/permanent psychosis. Despite seeing a psychiatrist, neurologist, and psychologist, I don't know if there is any record of Adderall induced psychosis for him for research data and statistics purposes. It makes me wonder how common it may be. It seems purely criminal that it is not listed in the drug warnings that it can cause permanent/persistent psychosis, when it seems to be a known thing to be a possibility by the medical professionals we have spoken to. Though, even they find it perplexing and not understood.
I'm sorry to hear that your son (and your family) has had such a horrible experience. You didn't mention whether or not he has been prescribed antipsychotics, which in all cases I have seen, have had positive benefits in stopping psychotic symptoms, and can later be discontinued. The most recent evidence is that amphetamine (Adderal) based products have about 1/500 rate of causing psychosis, but we don't know all of the factors that make some individuals vulnerable.
My friend is abusing Adderall and swears he’s having telepathic conversations with his neighbor through the wall of their apartment
I hope your friend gets help quickly. It's interesting how psychosis often shows up in certain ways within a culture. The hearing /communicating through walls/floors/ceilings with apartment neighbors is really quite common.
Crazy! Cuz my bf uses that exact vocabulary! Neighbor's communicating w him telepathically!!! Only telling him horrible thing's and haunting idea's. I look 4ward to when he gets the help he desperately wants and deserves! Sooon!
One can take it as prescribed and still experience drug induced psychosis. Be careful
@@DrJohnKruse The universality of the shadow-people experience is fascinating too.
My brother has been in a amphetamine induced psychosis for 4 months now (speed). It’s his second time… it also happened back in 2015. In four months, he lost his girlfriend, his car, his job and his apartment. He is homeless now and no matter what we tell him, he won’t get help. He says he is completely fine. He spent 6 days in the hospital recently and they game him an Abilify injection that should last a month. I had hoped it would help him but he doesn’t seem better. He is still delusional… My brother used to be kind, generous, a little shy and very intelligent. Now he is arrogant, impatience, manipulative, paranoid and mean. We don’t know what to do… How can we make him realize he is in a psychotic state?
Part of the nature of the condition is denial of the condition. Maybe with enough people delivering the same message, that he needs help, it may sink in, but odds are low. It may be more productive to work on the mental health / adult protective services end, to let them know that interventions so far have been ineffective, and that he is not taking adequate care of himself, and would probably benefit from staying in the hospital until his psychosis has cleared this time.
@@DrJohnKruse Thank you for answering 🙏
Thank you Dr. for this video. Very interesting
Bless you for spreading awareness!!
Thank you. Feel free to share with anyone who might appreciate it.
Thank you for the lecture doctor, enjoyed it. I, myself have ADHD and I’m currently on Adderall immediate release 15mg BID. I’ve been taking these for years with only insomnia as an issue when I was taking 20mg twice daily which is why we decreased to 15mg twice daily and that dosages helped the most with the least amount.
Thank you for sharing. I hope that it continues to work for you and that you sleep well.
Thanks Doc. I needed to hear this. 😒
I could be a spokesman for stimulant psychosis..led me to be arrested in Mexico twice yes that event happened wasn’t hallucinating was visiting my ex in Aguascalientes Mexico..I pray for everyone that’s caught up in substance abuse and their family members..maybe we America should do forced rehabs..
Thanks for sharing your unfortunate experiences and letting it be a warning to others.
I am concerned for my close family member. There have been 3 past instances that I know of, all while taking adderall, that she has accused her husband of being involved in illegal sexual activities. Currently, taking adderall again, she believes he is causing harm to their children, and legal action has been taken to keep her away from them. She does not believe anything is wrong with her, but the phrase “not normal” comes out of her mouth constantly. She gets very aggressive. We want to help her but don’t know how as she doesn’t believe the medication is causing a problem.
this definitely happened to me. i was on the verge of checking myself into a psychiatric ward. It happened when i increased my dosage and now i after reading the comments im worried about taking my medication.
Other experts may have different opinions, but my advice for anyone who truly had a psychotic experience induced by stimulant medications would be to avoid all doses of that medication from that point on.
I nearly checked myself in about 3 weeks after being prescribed it. Became disoriented, anxious, paranoid, and suicidal. I tend to be very sensitive to all stimulants in general (can’t have caffeine).
I have never been an aggressive or hostile person, but while on this medication I smashed my guitar and phone - other behaviors that I look back on without even recognizing myself. Truly horrific and never taking a stimulant again. Know many who are great on them though. Hope you are better.
This happened to my son. Was Prescribed low dose extended release.
THIS SHOULD BE TALKED ABOUT MORE!!
Thankyou I was perscribed Ritalin at the age of 6 for 10 years at the time, and I gradually got psychosis over time. I had no clue what was going on and later found out how/what caused it
marijuana cured it strangely enough cus it can cause psychosis as well but I’ve never had any symptoms from it thankfully and it helps my adhd as well as a whole range of other things
I still have a hard time eating 8 years after stopping Ritalin
This shouldn’t be perscribed to kids, it’s quite criminal
Yes, we should talk about this more, and every patient should be aware of this potential risk before being prescribed a stimulant, as part of a robust informed consent process.
@@DrJohnKruse absolutely
I have taken speed for the last 30yrs and now im on Dexamphetamine perscribed by the drug and alchol clinic where as i was doing up to 7grms aday im now down to half a grm a day due to me also taking dexys i have suffered from psychosis spelt wrong lol it lasted 3wks after a doctor who came to see me i came out of it it did frighten me ) but i still take every day i think if i did stop then i would die i dont think i could ever give it up for good but at least from 7grms a day to half grm is a big difference not to mention i did hit it up and now drop it
My brother recently got arrested for a slew of crimes right after being prescribed adderallXR 30 miligrams.
better than the crimes he'd do if he was on benzodiazepines.
My wife made accusations against me in 2020 that involved SA on my daughters. I was cleared of wrongdoing and it led to our divorce. I found out that she had been taking and abusing adderall for years but since it was prescribed the court wouldn't do anything. 3 and a half years later the accusations have persisted and expanded to neighbors, imaginary people etc. She constantly has accused me of planting cameras in her car and home, hacking her devices and stalking her. She has accused me of persuading other people to stalk her as well. About a month and a half ago, she accused me of abusing my daughters again. Ive found out that she has had the police at her home nearly 20 times in a year and a half. The police investigated her claims and suspect she was coaching my girls (they are 6 and 8 now). CPS found the same thing. We now have an ad litem who is investigating as well. Im fighting for custody of my girls now and it seems likely i will get it. It's been a nightmare and absolutely destroyed my family. My daughters tell me that mommy says people are watching them through AC vents and planted cameras. Is it possible she could get better?
In my experience, completely stopping Adderall is essential, and many people do have their psychosis resolve with antipsychotic medications. Best wishes, it sounds like you have had many horrible years.
Dr. Kruse (I like your German like name :) )
Can you make a video on Kratom?
It is a plant that has opioid- like effects. It has allowed me, and presumably hundreds of thousands of others, to discontinue illegal opioid/opioid use.
Thanks for the suggestion, I will put it on the list.
@Doctor John Kruse is it advisable to get a spouse who's just had a methamphetamine induced psychosis to get them to be on methadone programe so as to control their urges of not using as they're a father of two children. They are hostile most of the time, paranoid delusions. They don't live with the children but which drug programme is best for their state of mind.
Unlike the rest of the stimulants, Ritalin is not a dopamine releaser and I think its effect on norepinephrine is almost negligible. Anything but a baby dose of Ritalin would give me agitation and a transient minor paranoia. Ironically, modafinil causes me the worst case of that which leads me to think that it could be its effect on histamine that agitates me the most. I would like to know the difference between psychosis and dysphoric mania?
There are many people who label amphetamine induced psychosis as a mania. But in the few dozen people I have seen, everyone of them had paranoia as a primary aspect of their psychosis (which is not that common in mania), and none of them showed much, if any, positive affect, also uncharacteristic of mania.
I find it surprisingly fascinating but tragic that ppl seem to be affected w almost exact verbage when it comes to the audio hallucinations in the persecutory and jealousy delusional Disorders. I'm still trying to find research on this so any references would be GreatlyAppreciated!
I'm not aware of studies about using the same words, but it is striking. I know that more psychoanalytically oriented researches have looked at how the individual's culture can influence the content of delusions and hallucinations.
@Dr. John Kruse well, taking examples from comments>
One said the neighbors were communicating telepathically through the walls. Another example I heard, was saying voices were telling him demeaning and berating thing's, such as, ' I am Homo(homosexual) and a Chomo ( child molester). I don't know the sexual assault history of both, but in one case, the above voice examples applied to him. Telepathically, Neighbors, demeaning and insulting, mocking conversations.
🎯 Key Takeaways for quick navigation:
00:00 🧠 *Introduction to Amphetamine-Induced Psychosis*
- Definition of amphetamine-induced psychosis.
- Characteristics of amphetamine-induced psychosis, including hyperactivity and paranoia.
- Lack of awareness about the risk of amphetamine-induced psychosis in the medical community.
03:15 💊 *Long-term Consequences of Amphetamine-Induced Psychosis*
- Discussion of the potential long-term consequences, including the risk of permanent psychotic states.
- Limited research on the long-term outcomes of individuals who experience amphetamine-induced psychosis.
- The alarmingly high risk of long-term psychotic states in some cases.
08:06 💡 *Risks and Prevalence of Amphetamine-Induced Psychosis*
- The prevalence of amphetamine-induced psychosis and how it may be more common than generally believed.
- Factors contributing to the speaker's higher rate of encountering cases of amphetamine-induced psychosis.
- Variations in risk between different stimulant medications.
15:27 📊 *Research and Dosage Considerations*
- Lack of comprehensive research on amphetamine-induced psychosis.
- Speculation on the role of dosage and formulation (immediate release vs. extended release) in the risk of psychosis.
- The importance of considering lifetime exposure risk and the need for cautious prescribing practices.
17:44 ⚠️ *Treatment and Prevention*
- Treatment approach for amphetamine-induced psychosis, including discontinuing stimulant use and using antipsychotic medication.
- The speaker's strong recommendation to stay off stimulants indefinitely after experiencing amphetamine-induced psychosis.
- The crucial role of prevention in avoiding this serious condition, including involving a trusted person in the individual's life and recognizing early signs of psychosis.
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I have speed induced psychosis it can be brought down very close to complete aymptomatic levels by taking N Acetyl Cysteine. It works much better than the psych meds I was on. One must also not use speed of course.
I haven't heard of this approach, but am glad that you found something that worked for you.
What's the dosage and can you elaborate? I will indeed, do my own research but I'm v interested
@@jazpurgarcia831 doses of N-Acetyl Cysteine (NAC) in 2000 -3000 mg a day have been used successfully for some mood and anxiety disorders, but most still consider the approach experimental until we amass more research.
my friend has been hospitalized twice, and broke out once. hes bsck in hospital, found with a gun, in some bushes, and wont eat bc he ssys nurses are poisoning him. he lies to his dr who prescribes aderral.
With HIPAA regulations in the US, a doctor can't talk about his patient without that patient's consent, except in rare emergencies or other unusual exceptions. But psychiatrists and other doctors are allowed to, and encouraged to, listen to any medically relevant information any other person may have about a particular patient. So if you are concerned that the prescribing doctor doesn't know about what is going on, it may well be in your friend's best interest for you to pass your information on to the doctor. You can also request anonymity.
Hi i use for 2 months everyday amphetamin like 3 g everyday i stops but i have psyhosis and its bigger hoe to treat without medicament , ehen i sleep i wake up and cant breave , i dont know where i am its like in other planet i dont fell nothing everything is faster for me when i look in something the thing start to move to left or right , my mind is going really crazy i think that my best friend love me so hard but she like me as friend , i cant breave i cant take it i think that everyone is watching and laught at me what to do
It will goes better without treat ?, i getting stupid everyday i cant i just pff in 2 weeks for 1 day i am okay
Hello Dr. Kruse,
I am a pharmacist who recently was pulled out of Adderall induced psychosis. I was prescribed Adderall for the first time in 2019, starting with a 30 mg ER capsule and one 20 mg IR tablet. I did not like the drug initially and had communicated my experience to my prescriber who then added another 20 mg IR tablet, making my Total daily dose 70 mg. As the pandemic overwhelmed retail pharmacy, the fuel provided by Adderall was welcomed. Unfortunately, I was hit with several tragedies, as many of us were during the pandemic, and easily lost myself. I agree with your advice; it is imperative a close friend or family member be made aware that one is taken this drug. I did not make anyone aware and it’s hard for one to be able to differentiate reality from their induced psychosis. Between long work hours coupled with insomnia and dealing with family losses, I quickly became a slave to the drug. The insomnia only demanded that I continue to take the drug as it became my means of energy. I separated from my wife for a period as a result of the mass paranoia associated with adderall, and even engaged in mischievous activity. After I found myself on a highway in an imaginary high speed chase (no one was really out to get me), did I come forward to my wife who then checked me in to rehab. I feel back to my healthy well-natured self after disengaging from the drug entirely. I am grateful for my wife and to the education you have provided. My question to you would be, how can I effectively communicate or even prove to my board of pharmacy that the mischievous/abnormal behavior I committed was due to the adverse reaction of Adderall, as I defend my professional license? I can provide further details if needed.
Thank you
I was a mental health therapist and the exact same thing happened to me. Literally the same thing. Driving on the freeway thinking every car was following me leading to an inpatient hospitalization. I lost my job, almost got divorced, and lost my house. I'm currently on a mood stabilizer and abilify and my psychiatrist wants to wait 6 months before taking me off any meds. I dont have any advice but my moods are up and down between depression and anxiety and it's really hard because I'm also a mother. I wish my old doctor would have not ever prescribed me Adderall but what's done is done. I'm praying hard that my brain will rebalance and doing my best to just take care of myself. Standing in solidarity with you.
Are people who have had prior bad or unusual reactions to other classes of drugs more susceptible to amphetamine induced psyochosis.
There's extremely little research on this question. "Bad or unusual reactions" is a pretty broad category, but I would not feel comfortable prescribing amphetamine to anyone who had psychotic experiences for any medication or non-medication reason.
Very scary. Young people are abusing adderall with THC. What are the recovery recommendations?
For anyone who has had a psychotic experience, number one would be to avoid both substances forever. If psychotic symptoms are still present, most antipsychotics appear to be effective. I often use Abilify, which also seems to partially address ADHD symptoms in some people.
@@DrJohnKruse thank you so much for your help 💕
I shot heroin and cocaine for 10 years. Stopped. Tried speed a couple times. No thank you. It’s Exactly opposite of what I looked for in street drugs…
I have been diagnosed with bipolar schizoaffective disorder because of this.
I was on an antipsychotic for about 3 months and abstained from stimulants. It came back as I work night shift once every six weeks. I'm now in a position where I have to possibly live with a misdiagnosis for a long time. How long do I have to stay on antipsychotic medication?
That's a decision that should be made between you and your doctor after a detailed exploration of how long you have been without any psychotic symptoms, and whether sleep deprivation/ interruption or other possible destabilizing events are likely in your world.
@@DrJohnKruse thanks Dr Kruse.
There is one stimulant I haven't abstained from: Nicotine from Vaping. I have never experienced mania or psychosis and delusions as I had while taking methylphenidate. My treatment was normal doses (18, 36 and 54mg) of Concerta and the delusions were at their worst when I went off the stimulant, but I had never before vaped while on adhd medication and I think if I don't have some sort of thought disorder, the vaping may have contributed.
It's very difficult to quit but change over to tobacco the last week or so and feel calmer.
Isn't predisposition and genetics an important factor of whether a person will have psychosis or schizophrenia episodes triggered by any substance???
Presumably, but we don't have extensive research illuminating what risk factors are most important, or what protective factors may shield some people with genetic predispositions.
Just would hate to see people that could benefit greatly from this medication be scared away by information that pertains to quite a small percentage of patients. Now people who use or would use recreationally or for other reasons and not prescribed it are a totally different thing.
@@jlande6 I think informed consent requires talking about real life consequences. Whether 1/500 or so is quite a small percentage or not is a value judgment, but given the severity of the possible outcomes, we need for people to be aware. Especially since outcomes are likely to be better if they stop medications immediately on the appearance of psychotic symptoms, which is more likely if they, and loved ones they are in daily contact with, are aware that this is a potential side effect.
As I point out in the video, I know that I make a bigger deal of this than many other practitioners, but partly because I saw quite high rates of this, over 1/100 individuals, but I treated people who had risk factors for making psychosis more likely.
Why is this subject so suppressed ? Mental illness is not a virtue.
Great question. I think that both the whole topic of ADHD and of medication for psychiatric conditions have been historically treated with such stigma, that the professionals wanted to sweep any real problems under the rug, or more kindly, did not want to scare people off by discussing uncommon (but really serious) possible side effects.
Furthermore, amphetamine induced psychosis is uncommon enough, that many psychiatrist have not actually seen a case of it.
If you taking stimulant medication. YOU NEED SLEEEP. YOU NEED SLEEP YOU NEED SLEEP. GETTING SLEEP PREVENTS ALL SIDE EFFECTS
I agree that getting sufficient good quality sleep is important for those with ADHD, particularly those taking medications. But, no, it will NOT prevent all side effects.
Help!!! What do I do, when I was not so long ago, the only single person he trusted, to share the voices and what they were saying > we had to drive away from his home, to a distant parking lot,.for fear they( vioces) could and in triggered residence he could here her ck(ll)llllll)
This sounds like a compelling mental health emergency. He needs to be evaluated and treated, which may include hospitalization or antipsychotic medications or both. Stopping further consumption of stimulant medications also is very important. Your local hospital should have staff who can do a psychiatric evaluation.
@@DrJohnKruse my, inquiry/comment was incomplete = we became acquainted thru mutual individuals, he was involved in getting my Scooter running. That was Jan 2022. Feb 13, by his initial confidence to me, expressing desire to stop heroin, I assessed and successfully aided in this mission by way of suboxone and support. Things evolved. I did not know he had many accidents involving brain trauma > twice as child in México, 3x's as adult in severe car accidents none involving police or blood or hospitalization. Then, March 30th, he confided in these voices. They were escalating and he was not sure when they began. Demoralizing, humiliating, threatening, (telling him he's a homo and a chomo), that these voices were those of his neighbors, specific people, communicating with him " telepathically". He was increasingly becoming tormented no longer having opioid saturation to drown them, but worsened by a continued use of methamphetamine. Convincing him the urgency to stop this, helped some, but only when he was able to be drawn away from his home, near those neighbors voices, would he feel most at ease. This was with me. Yet, incidents would regularly occur and suicidal ideations would become prominent. Fast 4ward to County Mental Health involvement. Initially I was advocating, attending all his appts, because he was such a state, unable to express his conditions or articulate w any confidence. Dialed him into this MAT program. That begins end of May,to date. He slowly starts getting his independence (vehicle running), attends weekly testing, is starting to work here and there(architectural landscaping and design), but would slip, once a month and the results would be devastating, mostly, interrelational compounded w delusions. Brain scan had to be specially ordered. Program ppl , health care team , is drug focused> seroquel- Risperdal > despite his preexisting health conditions where both these anti psychotics exasperate ALL of his hereditary issue's. None are discussed. None are addressed. Side affects never mentioned. Trauma therapy never initiated. Weeks in, I would reappear Questioning ALL these issue's plus some. He's never been in the system for anything. I have experience both personally, familial, college degree and vested interest in mental health in general, in this case, his diagnosis was ,by them, agreeably Residual Meth Induced Psychosis. That up to 2 yrs till thing's might subside. He's 30yrs old, was NOT diagnosed w ANY pschitzophrenia or similar. Still, limited to no Trauma therapy, Addressing of voices, visual hallucinations he had experienced, childhood trauma's I had raised to attention on every occasion, but little to nothing was taken seriously. Scan of brain came bk w nothing noticeably wrong. Then, out of no where, something triggered his hidden fragile mind, and he goes on a brief, like a 20 min smoke meth use(I'm guessing cuz I wasn't there, but it wasn't long nor very much) and THAT would launch the voices turning on me. Convinced I'm cheating out of no where or at best, severely mis perceived observations. He then would leave my place where he'd been living since May, and returned to Mom's where neighbors, this is beginning of August, this stint caused him hallucinations that saw me " w my new bf, his neighbor, vandalizing his truck, having sex outside his house by a tree, I was seen wearing black latex gloves, feared I was trying to poison his family, and trying to break into his house to put something in his room. That I was basically torturing him- didn't want to i have to call cops cuz he cared 4me and didn't want me in trouble....
All this was texted to my brother in another state, at 5am over an hours of time- additionally, he's msging and voice mailing my good friend half hour away. NONE of these were reality. None gets reported to his doctor's. It was HELL convincing him it were drug induced psychosis delusions. We reconcile, he slips, each time, those delusions are drudged up again in a milder but ever disturbing fashion. To Oct 6th the last incident of no convincing and no further counseling, only an admission we broke up cuz of his delusions. No questions about those delusions, his Risperdal, .5, he was not taking, upped to 1mg. Also, Sept26th, visit w the prescribed doctor, summary of visit state's At bottom of page, Schitxoaffective disorder, unspecified. He told me cuz he told him he was still troubled by voices.
But now, He's not being treated for delusional Disorder. Only drugged.. and I'm left out of it all cuz I was perceived to still be cheating. It's the most insidious thing I've ever experienced. Sorry for the long ass narrative.
@@DrJohnKruse they upped his Risperdal to 2mgs. We just spent 2 days together after over a month since his last breakdown. Told me he's frustrated cuz he feels nothing different in his mind. They don't care about what his voices or delusions are saying or what they've entailed. Says he checks in, drug tests, is always clean(but, does not include the chipping done immediately after testing> tho> not frequent he slips) and feels like they aren't really invested in his well being when they only want to drug and up the dose of drug not doing anything. Over 6weeks they've upped his dose 3 times. I'm seeking alternative, specialized out of pocket care. I believe this clinic is not doing what they should be doing.
@@jazpurgarcia831 I'm sorry that you've been through such hell, and that the system was less than responsive to your useful input. I hope that your friend gets the help he needs, sooner rather than later.
@@DrJohnKruse thank you. Another thing, recently he asked his PCP to chk his glucose and blood sugars? Doctor told him They Were the experts, Not Me! Had told doc that I requested per his pre diabetes, high ALT, fatty liver and flagged cholesterol levels. Also, prescribed him Mitrozapine(?) an anti depressant, And he was never informed. His My Chart msg telling him scripts ready. On the traditional script bottle= in large print=
FOR METH CRAVINGS
never in my life have I heard nor seen such a violation of privacy, let alone, off label and saying daily for one week. He's experiencing many side effects and zero improvement on the voices. Still no therapy scheduled until Dec22. I've contacted his insurance and reached out to several top sources both state and county to address these concerns and get guidance. Additionally, I learned that back in late May, or early June, when he had filled out an official form giving me right's to his 411 and help w decisions, was never submitted( by them). I was not there when he did this but I distinctly recall when he came home telling me he had given me informed consent. I'm in process of re submitting this form and have been given a list of other mediCal recipient covered alternatives for mental health and and a new PCP. It's very sensitive now, since he has fixed delusions of me, breaching trust wobbling w confused confidence, feeling doubly betrayed by the current clinicians in this county clinic which IS REAL and those frm past, re me, that are NOT real. I'll kp you posted. I'm not going to give up or let this go without investigation!
I suffered what I think was stimulant psychosis a long time ago.
Now if I want to keep taking my study pills I need to take an anti-psychotic every day or things start getting weird again pretty quickly.
Is that normal?
@John Kruse That is indeed terrifying. Insanity is worse than death IMO
@@davesmith5646 your slogans only help you cope with the fact that Brandon won and the fascist lost.
Biden is put on speed when ever he needs to make speeches.
I haven't seen any evidence that would support this claim. On the other hand, go view my video on Donald Trump- when he had "important" speeches to make his pupils were dilated, his gestures were reduced to a third of his normal rate, and his sentences bore a much stronger relationship to his previous sentence - altogether very strong evidence that he was taking stimulants to control his executive function deficits on these occasions.
@@DrJohnKrusespare me your attempt. we all know they call Brandon sleepy Joe for a reason. He even daze and confuse in normal situations