NIDA InfoFacts: Stimulant ADHD Medications - Methylphenidate and Amphetamines
Stimulant medications (e.g., methylphenidate and amphetamines) are often prescribed to treat individuals diagnosed with attention-deficit hyperactivity disorder (ADHD). ADHD is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development. This pattern of behavior usually becomes evident in the preschool or early elementary years, and the median age of onset of ADHD symptoms is 7 years. For many individuals, ADHD symptoms improve during adolescence or as age increases, but the disorder can persist into adulthood. In this country, ADHD is diagnosed in an estimated 8 percent of children ages 4–17 and 2.9–4.4 percent of adults.1,2,3
How Do Prescription Stimulants Affect the Brain?
All stimulants work by increasing dopamine levels in the brain. Dopamine is a brain chemical (or neurotransmitter) associated with pleasure, movement, and attention. The therapeutic effect of stimulants is achieved by slow and steady increases of dopamine, which are similar to the natural production by the brain. The doses prescribed by physicians start low and increase gradually until a therapeutic effect is reached. However, when taken in doses and routes other than those prescribed, stimulants can increase brain dopamine in a rapid and highly amplified manner as do most other drugs of abuse, disrupting normal communication between brain cells, producing euphoria, and increasing the risk of addiction.
What’s the Role of Stimulants in the Treatment of ADHD?
Treatment of ADHD with stimulants, often in conjunction with psychotherapy, helps to improve the symptoms of ADHD, as well as the self-esteem, cognition, and social and family interactions of the patient. The most commonly prescribed medications include amphetamines (e.g., Adderall, a mix of amphetamine salts); methylphenidate (e.g., Concerta, a formulation that releases medication in the body over a period of time); and Ritalin, which is generally less potent than amphetamine. These medications have a paradoxically calming and “focusing” effect on individuals with ADHD. Researchers speculate that because methylphenidate amplifies the release of dopamine, it can improve attention and focus in individuals who have dopamine signals that are weak.4
One of the most controversial issues in child psychiatry is whether the use of stimulant medications to treat ADHD increases the risk of substance abuse in adulthood. The research so far suggests that individuals with ADHD do not become addicted to their stimulant medications when taken in the form and dosage prescribed by doctors. And, there have been several studies that report stimulant therapy in childhood does not increase the risk for subsequent drug and alcohol abuse disorders.5,6,7 However, more research in this area is clearly needed, particularly in adolescents treated with stimulant medications.
Reprinted with the permission of the National Institute on Drug Abuse.
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