Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects

In this episode, I explain how medications such as Adderall, Ritalin, Vyvanse and other stimulants work to increase focus and treat attention-deficit/hyperactivity disorder (ADHD). I explain the brain circuits involved in focus and the key roles dopamine and norepinephrine play in their regulation. Then I explain how stimulants such as Adderall and Vyvanse can increase focus and reduce hyperactivity in kids or adults with ADHD, and how and why Ritalin and other medications (e.g., Modafinil, Guanfacine) may work better for some. I explain the long-term effects of ADHD medications on height, cardiovascular health, hormones, predisposition to addiction and psychosis, and whether these treatments can be used and then stopped. I also discuss the immense individual variation in dosage sensitivity for these medications and the negative side-effects that occur from recreational use. This episode ought to benefit anyone with ADHD, their parents, those on ADHD medications or anyone curious about how these medications work.

Articles

• Cardiovascular Effects of ADHD Therapies: JACC Review Topic of the Week (Journal of the American College of Cardiology)
• Brain alterations in children/adolescents with ADHD revisited: A neuroimaging meta-analysis of 96 structural and functional studies (Neuroscience & Biobehavioral Reviews)
• Impulsivity, Compulsivity, and Top-Down Cognitive Control00068-7?returnURL=https://linkinghub.elsevier.com/retrieve/pii/S0896627311000687%3Fshowall%3Dtrue) (Neuron_)
• Dopaminergic System Dysfunction in Recreational Dexamphetamine Users (Neuropsychopharmacology)
• Modafinil enhances alerting-related brain activity in attention networks (Psychopharmacology)
• Association of Intrinsic Brain Architecture With Changes in Attentional and Mood Symptoms During Development (JAMA Psychiatry)
• Cognitive enhancement effects of stimulants: a randomized controlled trial testing methylphenidate, modafinil, and caffeine (Psychopharmacology)
• Psychostimulants and Cognition: A Continuum of Behavioral and Cognitive Activation (Pharmacological Reviews)
• Neural Correlates of Symptom Improvement Following Stimulant Treatment in Adults with Attention-Deficit/Hyperactivity Disorder (Journal of Child and Adolescent Psychopharmacology)
• Long-term effects of stimulant exposure on cerebral blood flow response to methylphenidate and behavior in attention-deficit hyperactivity disorder (Brain Imaging and Behavior)
• Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (Neurology and Therapy)
• Pharmacologic treatment of attention deficit hyperactivity disorder in adults: A systematic review and network meta-analysis (PLOS ONE)

Books

• Stahl’s Essential Psychopharmacology (4th Edition)

Other Resources

• Controlling Your Dopamine For Motivation, Focus & Satisfaction
• Leverage Dopamine to Overcome Procrastination & Optimize Effort
• ADHD & How Anyone Can Improve Their Focus