Is this really weaponised, though? His prescription is for 3-4 tablets a day, it sounds like he’s getting one in the morning then that’s it until the end of the working day in court. Based on his lawyer’s request, he probably can’t take it in court, so they’re asking for a long release tablet that will get him through the day.
It’s no good him getting a regular tablet at 8am if his case isn’t actually heard until after 12.
Literally all of what you just recited should be a discussion between him and his doctor. Doctors can and will have urgent consultations with patients, and one of the outcomes of those consultations can be “we’re switching to this new drug tomorrow”.
Neither judges nor lawyers can prescribe medication. No pharmacist in the US will fill a prescription without a doctor’s order - which they WILL check for schedule 2 substances (and these medications are generally schedule 2 substances).
This is 100% theatrics, which is where the vast majority of my ire on this topic is coming from.
Yes, they probably should have gone through the doctor first - and I think it’s likely it will get thrown out because the court only allowed him the drugs based on his prescription (unless they did bring something from a doctor and the article didn’t mention it). However that doesn’t mean it isn’t a valid point. He’s supposed to have 3-4 a day, so one every 4-5 hours, and if he’s in court 9-5 then at the latter part of the day the effects will have worn off. It’s entirely reasonable to tell the court that he can’t follow his prescription properly.
While he’s in the prison’s custody, it’s their responsibility to provide him with his prescribed medication, and the judge knows that they haven’t been doing so. The judge has been presented with a statement from the defendant’s HCP stating that he “will be severely negatively impacted in his ability to assist in his own defense,” but the judge is ignoring this because he thinks Bankman-Fried “seems fine.” That doesn’t piss you off? You’re lucky if you’ve never had to experience someone in a position of authority over you saying that you’re obviously fine when you know you’re not.
He has a prescription for 3-4x 10mg tablets per day. He has not been receiving that.
He also has a prescription for Ensam that he has not been consistently receiving. Ensam interacts with Adderall, and getting both of them inconsistently could have even more dramatic effects. I’m not sure how going off Ensam compares to other anti-depressants but many of them can have pretty rough side effects.
Per the CNBC article, he did get an updated prescription for XR Adderall, but - presumably because that has to go through the prison system - the judge indicated that won’t be available until Thursday. The judge refused to delay proceedings because he hadn’t gotten an updated medical opinion on the matter:
After the jury exited Monday, Kaplan addressed the issue, saying that he got notice that the extended-release Adderall that was requested would not be available until Thursday. The judge added that he had not observed a problem with Bankman-Fried in court and was inclined to proceed as planned. He did acknowledge that he was not a medical professional but noted that he had not received any updated medical opinions on the matter. “I can’t have lawyers giving drugs to people on trial,” he said.
I get the impression that he’s saying “I don’t care what your psychiatrist thinks. You’re not fidgeting or sobbing, so obviously your ADHD and depression aren’t big enough issues to delay the trial.”
Given that the medical opinion that Kaplan already received stated that it was important that Bankman-Fried receive his medication as prescribed, why does Kaplan need an update? Nothing has changed. This is the letter he received back in mid-August:
Dear Judge Kaplan:
Mr. Sam Bankman-Fried has been under my psychiatric care since February of 2019. Mr. Bankman-Fried has a history of Major Depressive Disorder and Attention Deficit Hyperactivity Disorder (ADHD).
For over 5 years, Mr. Bankman-Fried has been prescribed Emsam 9mg/24hrs transdermal patch.
The Emsam patch is FDA-approved for treatment of Major Depression. The oral version of this medication, is not FDA-approved for treatment of Major Depression. The transdermal patch allows 73% of the medication to enter the blood stream while the oral version delivers 4% into the bloodstream. Additionally, due to its interaction with the gut, the oral medication has a dangerous side effect, the potential for hypertensive crisis (a severe elevation of blood pressure), and thus it is not possibly to give a high dose of selegiline orally to compensate for the poor rate of delivery into the bloodstream. The patch is unique and there are no equivalent alternative treatments.
Of note, Mr. Bankman-Fried has tried other antidepressants (SSRI and Wellbutrin) and they were ineffective for his symptoms. Additionally, there have been times when Mr. Bankman-Fried did not have access to the Emsam patch (typically when travelling/abroad) and exhibited symptoms of depression, including lethargy, anhedonia, low motivation, and increased ruminations.
For the past 3 years, Mr. Bankman-Fried has been prescribed Adderall 10mg tablet 3-4x/day (the medication is FDA-approved for doses up to 45mg/24hrs) for ADHD. This medication has been effective for treatment of Mr. Bankman-Fried’s inattention and ADHD-related rumination.
Without the aforementioned psychiatric medications, Emsam 9mg/24hrs patch and Adderall 10mg tablets, Mr. Bankman-Fried will experience a return of his depression and ADHD symptoms and will be severely negatively impacted in his ability to assist in his own defense.
I don’t want this to be declared a mistrial or be appealed, but I firmly believe that not being given your prescription medication when you’re in court, despite your doctor having told the judge a month and a half ago that it was necessary, should be grounds for both.
Since you mentioned you have ADHD, can you answer a related question?
How do you find functioning with a reduced or missed dose? I’m not familiar with how the medication works, would you find it impacts your day to be given 1/4 your prescribed dose, or is that bullshit?
Further, if there was some impact, would that impact be worsened if you continued to take substantially less than prescribed, say for several weeks, or does it not compound like that?
It absolutely can and does affect a person if they don’t get their dose, or don’t get the full dose. The thing is, it’s incredibly subjective, and depends heavily on the drug involved as well as the person involved (as well as any comorbidities, psychiatric or otherwise, that may be present).
If I miss my dose and it’s before about 1 in the afternoon, I’ll just take it late. Much later than that, and I’ll likely have trouble sleeping.
For me, there is no “medication debt” per se. I don’t believe the way the drugs interact with the condition itself actually lends itself to that concept at all, but others may experience it differently than what is enumerated in textbook cases.
But the thing is that, under the current circumstances, lawyers and judges have zero reason to be getting involved with this dudes psychiatric care and his legally-given and -obtained prescriptions. The dude is clearly leaning into the “misunderstood genius” or some similar narrative bullshit. This has just about zero bearing on the trial. He’s grandstanding because he or his lawyers think it will make one or more people on the jury sympathetic to him.
If I was the judge here, I’d have responded: “Didn’t ask; don’t care. At this point, I fully expect you to handle your medical and psychiatric care yourself.”
That’s not really how it works with ADHD. You and your psych experiment with drugs and doses that they prescribe you over an extended period of time, then you stick with the one that works and also has the most minimal and manageable side effects. You generally don’t go up and down based on subjective transients - at least, not with this level of responsiveness.
Also, if he’s angling to get court-ordered additional adderall instead of going through proper psychiatric/pharmaceutical channels, that makes me strongly suspect that this is all bullshit.
Yeah I wouldn’t dismiss his mental state or struggles because it doesn’t fit a narrative. Let the man have his drugs if it helps, what’s exactly the issue that we need to turn this into a debate. Kinda shouldn’t even be talking about his meds tbh.
I find it extremely frustrating when someone overtly, ham-handedly, and very publicly leans into negative stereotypes of the condition that I have lived with for decades, thereby perpetuating and exacerbating said negative stereotypes in a very reductive fashion.
As someone with ADHD, the fact that he’s trying to weaponize his condition in a legal setting is a little bit infuriating.
Is this really weaponised, though? His prescription is for 3-4 tablets a day, it sounds like he’s getting one in the morning then that’s it until the end of the working day in court. Based on his lawyer’s request, he probably can’t take it in court, so they’re asking for a long release tablet that will get him through the day.
It’s no good him getting a regular tablet at 8am if his case isn’t actually heard until after 12.
Literally all of what you just recited should be a discussion between him and his doctor. Doctors can and will have urgent consultations with patients, and one of the outcomes of those consultations can be “we’re switching to this new drug tomorrow”.
Neither judges nor lawyers can prescribe medication. No pharmacist in the US will fill a prescription without a doctor’s order - which they WILL check for schedule 2 substances (and these medications are generally schedule 2 substances).
This is 100% theatrics, which is where the vast majority of my ire on this topic is coming from.
Yes, they probably should have gone through the doctor first - and I think it’s likely it will get thrown out because the court only allowed him the drugs based on his prescription (unless they did bring something from a doctor and the article didn’t mention it). However that doesn’t mean it isn’t a valid point. He’s supposed to have 3-4 a day, so one every 4-5 hours, and if he’s in court 9-5 then at the latter part of the day the effects will have worn off. It’s entirely reasonable to tell the court that he can’t follow his prescription properly.
While he’s in the prison’s custody, it’s their responsibility to provide him with his prescribed medication, and the judge knows that they haven’t been doing so. The judge has been presented with a statement from the defendant’s HCP stating that he “will be severely negatively impacted in his ability to assist in his own defense,” but the judge is ignoring this because he thinks Bankman-Fried “seems fine.” That doesn’t piss you off? You’re lucky if you’ve never had to experience someone in a position of authority over you saying that you’re obviously fine when you know you’re not.
He has a prescription for 3-4x 10mg tablets per day. He has not been receiving that.
He also has a prescription for Ensam that he has not been consistently receiving. Ensam interacts with Adderall, and getting both of them inconsistently could have even more dramatic effects. I’m not sure how going off Ensam compares to other anti-depressants but many of them can have pretty rough side effects.
Per the CNBC article, he did get an updated prescription for XR Adderall, but - presumably because that has to go through the prison system - the judge indicated that won’t be available until Thursday. The judge refused to delay proceedings because he hadn’t gotten an updated medical opinion on the matter:
I get the impression that he’s saying “I don’t care what your psychiatrist thinks. You’re not fidgeting or sobbing, so obviously your ADHD and depression aren’t big enough issues to delay the trial.”
Given that the medical opinion that Kaplan already received stated that it was important that Bankman-Fried receive his medication as prescribed, why does Kaplan need an update? Nothing has changed. This is the letter he received back in mid-August:
I don’t want this to be declared a mistrial or be appealed, but I firmly believe that not being given your prescription medication when you’re in court, despite your doctor having told the judge a month and a half ago that it was necessary, should be grounds for both.
Since you mentioned you have ADHD, can you answer a related question?
How do you find functioning with a reduced or missed dose? I’m not familiar with how the medication works, would you find it impacts your day to be given 1/4 your prescribed dose, or is that bullshit?
Further, if there was some impact, would that impact be worsened if you continued to take substantially less than prescribed, say for several weeks, or does it not compound like that?
Thanks in advance!
It absolutely can and does affect a person if they don’t get their dose, or don’t get the full dose. The thing is, it’s incredibly subjective, and depends heavily on the drug involved as well as the person involved (as well as any comorbidities, psychiatric or otherwise, that may be present).
If I miss my dose and it’s before about 1 in the afternoon, I’ll just take it late. Much later than that, and I’ll likely have trouble sleeping.
For me, there is no “medication debt” per se. I don’t believe the way the drugs interact with the condition itself actually lends itself to that concept at all, but others may experience it differently than what is enumerated in textbook cases.
But the thing is that, under the current circumstances, lawyers and judges have zero reason to be getting involved with this dudes psychiatric care and his legally-given and -obtained prescriptions. The dude is clearly leaning into the “misunderstood genius” or some similar narrative bullshit. This has just about zero bearing on the trial. He’s grandstanding because he or his lawyers think it will make one or more people on the jury sympathetic to him.
If I was the judge here, I’d have responded: “Didn’t ask; don’t care. At this point, I fully expect you to handle your medical and psychiatric care yourself.”
That’s good info, I appreciate your personal insights on the condition.
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More stressful situations require more drugs to calm down. Makes sense, doesn’t it?
That’s not really how it works with ADHD. You and your psych experiment with drugs and doses that they prescribe you over an extended period of time, then you stick with the one that works and also has the most minimal and manageable side effects. You generally don’t go up and down based on subjective transients - at least, not with this level of responsiveness.
Also, if he’s angling to get court-ordered additional adderall instead of going through proper psychiatric/pharmaceutical channels, that makes me strongly suspect that this is all bullshit.
I mean, he is in jail, so the normal channels likely aren’t available to him.
Yeah I wouldn’t dismiss his mental state or struggles because it doesn’t fit a narrative. Let the man have his drugs if it helps, what’s exactly the issue that we need to turn this into a debate. Kinda shouldn’t even be talking about his meds tbh.
Eh, don’t associate by condition.
Like, it isn’t a club or whatever, you’re an individual, and your needs are individual.
Ok, sure, I’ll use more words:
I find it extremely frustrating when someone overtly, ham-handedly, and very publicly leans into negative stereotypes of the condition that I have lived with for decades, thereby perpetuating and exacerbating said negative stereotypes in a very reductive fashion.
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You don’t seem to understand how neurodivergence works. Like, at all.
You gonna tell me to just be less depressed and have a better work ethic next?