How ADHD medications Really Work
Stimulant medications like Ritalin and Adderall are often given to children with ADHD. In the United States, about 3.5 million children between 3 and 17 years old take these medicines, and the number keeps growing as more children are diagnosed.
Most people think the drugs help children pay attention better, but new research shows that this isn’t exactly how they work.
A large study from Washington University School of Medicine (WashU Medicine) found that these medicines do not directly change the parts of the brain that control attention. instead, the drugs make the brain feel more awake and make tasks feel more interesting.
When a child feels more alert and finds a task more rewarding, it becomes easier to stay with that task, even though their basic ability to focus has not changed.
ADHD, stimulants, and focus
For many years, doctors and researchers believed stimulants helped children focus by strengthening brain regions responsible for attention control.
Dr. Benjamin Kay, an assistant professor of neurology at WashU Medicine, noted that this view shaped his own medical training.
“I prescribe a lot of stimulants as a child neurologist, and I’ve always been taught that they facilitate attention systems to give people more voluntary control over what they pay attention to,” said Dr.Kay. “But we’ve shown that’s not the case.”
Rather of seeing changes in attention networks, the research team observed the strongest effects in areas related to arousal and reward.
These regions influence how awake the brain feels and how worthwhile an activity appears, both of which strongly affect behavior.
ADHD medications change the brain
To understand how stimulants change brain activity, the researchers analyzed resting state functional MRI data from 5,795 children aged eight to eleven who participated in the Adolescent Brain Cognitive Growth study (ABCD study).
Resting state scans measure brain activity when no specific task is being performed, allowing researchers to examine underlying brain organization.
Children who took stimulants on the day of scanning showed increased activity in brain regions linked to wakefulness and reward.