Why stimulants work for adhd

Huang, H. Harvard Review of Psychiatry, 28 2 , — Adler, L. Management of ADHD in adults. The Journal of Clinical Psychiatry, 63 Suppl 12, 29— Volkow, N. JAMA, 10 , — This holiday season alone, millions of people will turn to HelpGuide for free mental health guidance and support.

So many people rely on us in their most difficult moments. Can we rely on you? All gifts made before December 31 will be doubled. Cookie Policy. What you need to know, including common side effects and tips for taking them responsibly. Stimulant medications for ADHD Stimulants are the most common type of medication prescribed for attention deficit disorder. Short-acting vs. Common side effects of stimulants include: Feeling restless and jittery Difficulty sleeping Loss of appetite Headaches Upset stomach.

Irritability, mood swings Depression Dizziness Racing heartbeat Tics. Any type of heart defect or disease High blood pressure Hyperthyroidism. Glaucoma High levels of anxiety A history of drug abuse. Strattera Suicide Risk in Children Strattera may increase suicidal thoughts and actions in some people, especially children and younger adults who have bipolar disorder or depression in addition to ADHD. Self-calming techniques, deep breathing, and yoga can often help children with ADHD. Has the school tried to teach my child to be more attentive and less active?

What is the decision to put my child on medication based on? Is it the result of behavioral observations over time and in different settings, such as in school and at home? When is my child at their best? Fishing with an uncle or playing video games? Help the physician understand how pervasive or selective the problem is. Does my child have other conditions that can be mistaken for hyperactivity?

Children exposed to toxic chemicals or who have undiagnosed learning disabilities and low-level anxiety disorder may demonstrate similar behaviors. Source: Family Education Network. Do you think the dosage or medication is working?

Does your child think the dosage or medication is working? Does the dose need to be increased or decreased? What was the change in a specific behavior or set of behaviors that caused you to conclude that the medication needed to be evaluated?

Is your child experiencing any side effects, such as headaches, stomachaches, fatigue or sleeplessness, or suicidal thoughts if taking Strattera? What is the likelihood that those side effects will last? Ask your doctor. Do you or your child think a medication or dosage level has stopped working? They tend to reduce interruptive behavior, fidgeting, and other hyperactive symptoms.

But recent assessments of chronic benefit are less impressive. In the first naturalistic study of ADHD-diagnosed adults treated with drugs for longer than 4 years, the score on a measure of mental health functioning was not different between those who were still on treatment and those who were no longer taking the medications Lensing et al.

In a similar review of randomized clinical trials in adults, Castells et al. This was in spite of the fact that methylphenidate was more efficacious than placebo in reducing symptoms.

In brief, even when the drugs are effective in reducing symptoms, ADHD patients often discontinue their stimulant medications. A recent study of this issue found that improvement in ADHD inattention and severity rating scores were not associated with functional improvement Buitelaar et al. In other words, symptom reduction does not always improve quality of life. There is a similar disparity between the efficacy of stimulants, either amphetamine or methylphenidate formulations, for ADHD symptoms and their effect on cognitive performance.

Reviews of this topic de Jongh et al. The most recent review of long-term ADHD medication on academic outcomes in youth Langberg and Becker, confirmed these earlier conclusions. As with all previous reviews, they found modest, but clinically unimpressive, improvement in several areas, including achievement test scores, grades, and grade retention.

Ilieva et al. No cognitive outcome was enhanced although, as often reported with stimulants, there was some slight improvement in those with lower baselines. Despite this objective outcome, participants believed their performance was more enhanced by the drug than by the placebo.

In brief, concern about the recent resurgence in illicit stimulant use and the ethics of stimulants as cognitive enhancers is ironic given the lack of evidence that they actually do enhance cognition. But this raises the question: Why do drugs that acutely increase attention and concentration produce so little long-term intellectual benefit?

For several years, we have conducted studies in college undergraduates to address this question. We used several types of tasks, ranging from motor dexterity, saccadic eye movements, attention, verbal fluency, memory acquisition and retention of word lists , distractibility, and problem solving Barrilleaux and Advokat, ; Advokat and Vinci, In general, ADHD-diagnosed college students were not severely impaired on these tests relative to their normal peers.

This was not surprising; all participants had been admitted to an accredited 4-year college. Because we did not do any assessments to confirm the diagnoses, it is reasonable to assume that some unknown proportion of the diagnoses were questionable. Even though we required that all participants provide a prescription for stimulants before they could be accepted into the study, we did not validate their diagnoses.

On the other hand, the presumed cognitive effect of stimulants is not thought to be restricted to the ADHD population. Stimulants are also assumed to be capable of improving intellectual performance in cognitively normal individuals, although they usually are more effective if the baseline measure is below normal. In other words, we should have been able to detect some improvement even if the ADHD diagnoses were not valid.

For that matter, it was also possible that some of the non-ADHD control group might have correctly been diagnosed with ADHD if they had been evaluated. Our results can be summarized as follows: First, consistent with ADHD symptomatology, non-medicated ADHD students were more likely to be impaired on tasks that required some type of inhibitory reaction, in which they had to withhold their responses until the correct choice could be made Barrilleaux and Advokat, Second, in most of our procedures, although performance was improved by stimulants, the amount of improvement was usually not significantly different from the normal, control, level.

That is, ADHD-diagnosed students often did better on the neuropsychological tasks when they were on their medication, relative to when they were not. But, in most cases, neither result was different from the performance of normal students. Third, in those cases where the drugs did improve performance, the result was not due to the fact that stimulant drugs simply made the responses faster; it occurred whether the drug increased or decreased reaction times.

It is not surprising that the most reliable effect of stimulants in our studies, as well as that of others Advokat, ; Advokat and Vinci, , is to reduce impulsivity, since that is one of the reasons they are prescribed. In fact, these drugs also reduce impulsivity in healthy adults de Wit et al.

But, a decrease in impulsivity would presumably be a beneficial effect; it would not explain why the drugs don't improve academic outcomes. We then considered another alternative.

Academic environments are inherently anxiety provoking, and arousal is known to affect memory. Modest levels can improve memory but too much anxiety will impair memory. This classic behavioral principle, known as the Yerkes-Dodson law, is often expressed in the form of an inverted inverted-U function.

While it may not be supported in all types of situations, this relationship is more likely to be obtained with uncomplicated, simple, tasks. We hypothesized that perhaps adding a stimulating drug to the normal academic stresses of college produced too much arousal and impaired performance. To test this, we adapted a procedure developed by Cahill and McGaugh and used by Brignell et al.

The procedure consists of presenting a narrative slideshow that contains neutral passages and an emotional segment in the middle of the story. Participants watch the slides and listen to the story.

Several days later they are asked questions about the narrative, to see how much they recall. Inevitably, information from the emotional segments is recalled more accurately than the neutral segments. We gave the same narrative slideshow to a group of normal students, and two groups of ADHD students, who were either on or off their medications. One week later all the students returned, under the same medication status, to answer questions about the story Maul and Advokat, Story recall of control and ADHD adults.

Average score of each group in each story phase. We appreciate that, in contrast to the classic definition, we cannot conclude that the descending limb of the U is due to a continued increase in arousal during the second neutral story segment. The outcome mainly illustrates an example of emotionally enhanced recall, which occurred reliably in all three groups. In addition, the figure also shows that the performance of the non-medicated ADHD group was worse than the other groups on both, the first neutral segment, and on the emotional segment.

Last, the score of the non-medicated group on the final segment was the same as that of the other two groups and was significantly better than on their first neutral phase. These data show a substantial improvement, essentially normalization, of long-term, episodic, memory in medicated ADHD diagnosed adults. This result provides clear-cut evidence of cognitive benefit from stimulant drugs, and is one of the most dramatic examples of memory improvement demonstrated by stimulants.

The results are reminiscent of Izquierdo et al. After methylphenidate, only the older subjects showed improvement; their age-related memory deficit was reversed, and they remembered as much information as the younger subjects. Like stimulants, levodopa increases brain levels of the transmitter, dopamine]. In summary, our results show that stimulant medications can improve episodic memory in ADHD-diagnosed adults.

Like the outcome of the neuropsychological assessments, the data suggest that the drugs do have some cognitive benefit. That is, in addition to their well-known ability to enhance attention, we found that stimulant drugs can also improve episodic recall. Again, however, this does not explain why they do not improve academic performance. Maybe they had learned how to gain some academic benefit from the stimulants.

If that were true, they might not be academically impaired, relative to their non-ADHD counterparts. To find out more about the respective academic behavior of our undergraduates, we conducted a couple of surveys. In the first study Advokat et al. This is consistent with the results reported by Ilieva et al. Of course, we couldn't tell from these data how many students in the ADHD group actually used stimulant medications.

Nor could we tell if the GPA would be even lower if those students didn't use the drugs. That is, we couldn't tell if the drugs were effective, either because they worked or because the students believed the drugs worked. Use precise geolocation data. Select personalised content. Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights. Measure content performance.

Develop and improve products. List of Partners vendors. Stimulants are the most common type of medicine used to treat ADHD. They work by increasing the availability of certain chemicals in the brain, thus making the pathways in the brain work more effectively.

Our brains are made up of nerve cells called neurons , which are separated by tiny gaps called synapses. All brain and nervous system functions are based on how these neurons communicate across synapses. The neurons relay information to each other by sending chemical messengers or neurotransmitters across the synapses throughout the neural network. Some people get anxious or restless when medication wears off.

This is called a rebound effect. There are rarer side effects, too, like motor tics. Taking notes in an ADHD medication log can help you track side effects. Learn about other ADHD treatment options. And get tips to help with ADHD at home. But these differences can make it harder for parts of the brain to communicate with each other and get stuff done. Podcast Wunder community app.

Main menu Our work Blog Surveys and research. Join our team Privacy policy Terms of use Fundraising disclosure Sitemap. With ADHD, this process can get disrupted in different ways:.