Stimulants May Help your Brain (And your Kid's Brain)

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Main Chapters:
00:00 Intro
00:11 Take home message
02:44 Risks of Stimulants
03:57 Stimulant Studies on Rodents
06:31 Stimulant Studies with Humans
15:34 Analysis of Studies
20:07 Non-Medication Treatments that can Affect the Brain
20:50 Conclusion
21:59 Questions

Many parents are leery of allowing their children with ADHD start treatment with stimulants. They worry about stunted growth, and risks of substance abuse and addiction. One of the biggest concerns is that powerful stimulants might cause some form of permanent brain damage.

We do have evidence that abuse of methamphetamine, and of cocaine are associated with neuroinflammation and loss of brain cells. Rodent research has shown similar types of damage from methylphenidate and amphetamine. But those studies looked at dosages that entered the brain much more quickly and at higher levels than from therapeutic oral doses of prescription stimulants.

Numerous short term studies show that the immediate effects of stimulants are to normalize aberrant patterns of activation in the brains of those with ADHD. More than thirty long-term studies have found an association between long-term use of stimulants by children and adults with ADHD and brains that appear more like the brains of those without ADHD than do the brains of individuals with ADHD who never took medication.

Rather than damaging brains, the current evidence suggests that depriving your ADHD child of effective medication may increase the likelihood of persistent problems from ADHD.

References:
Effect of Psychostimulants on Brain Structure and Function in ADHD: A Qualitative Literature Review of MRI-Based Neuroimaging Studies (2013)
https://www.ncbi.nlm.nih.gov/pmc/arti...

A Longitudinal Study of Resting-State Connectivity and Response to Psychostimulant Treatment in ADHD (2021)
https://ajp.psychiatryonline.org/doi/...

Methylphenidate and atomoxetine normalise fronto-parietal underactivation during sustained attention in ADHD adolescents (2019)
https://www.sciencedirect.com/science...

Causal effects of psychostimulants on neural connectivity: a mechanistic, randomized clinical trial (2022)
https://acamh.onlinelibrary.wiley.com...

Effects of Stimulant Treatment on Changes in Brain Activation During Reward Notifications in Drug Naïve Youth With ADHD (2024)
https://journals.sagepub.com/doi/10.1...

Full Chapter list:
00:00 Intro
00:11 Take home message
02:44 Risks of Stimulants
03:57 Stimulant Studies on Rodents
06:31 Stimulant Studies on Humans
08:08 Studies using MRIs
09:01 MRI Studies Results
10:55 Studies using Functional MRIs
12:07 Functional MRI Studies Results
13:41 Studies looking at Functional Connectivity
14:31 Functional Connectivity Studies Results
15:34 Analysis of Studies
17:41 Cingulo Opercular Network (CON)
19:25 Heterogeneity within ADHD Groups
20:07 Non-Medication Treatments that can Affect the Brain
20:50 Conclusion
22:00 Questions
22:10 Do Stimulants Help Improve Neuroplasticity?
22:58 How long to see Brain Changes with Stimulants?
24:35 Skin Picking / Nail Biting and Mental Health
25:55 Do you Retain Benefits of Stimulants After Stopping?
28:14 ADHD Treatment Goals of Medication Response or Remission
30:05 Outro

Streamed live March 20, 2024

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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro-atypical brains can optimize their functioning in our shared, and somewhat strange, world.

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