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Adderall Risks: Much More Than You Wanted To Know | Slate Star Codex

I didn’t realize how much of a psychiatrist’s time was spent gatekeeping Adderall.

Dopamine makes you feel happy, but we probably still have to rewrite the textbooks -- ScienceDaily

"ADHD drugs are a type of amphetamine that targets and blocks DAT. This means that not all dopamine returns to the cell for reuse, and we may have difficulty feeling rewarded. It is even worse with a substance such as cocaine which completely blocks DAT, preventing all dopamine from returning to the cell. This means that the nerve cells will continue to want more cocaine until there is no more dopamine left and you start to feel depressed," Claus Juul Løland explains.

Could excessive sugar intake contribute to aggressive behaviors, ADHD, bipolar disorder? New peer-review paper looks at evolution and current Western diet to help explain manic behaviors -- ScienceDaily

The research, out today from the University of Colorado Anschutz Medical Campus and published in Evolution and Human Behavior, presents a hypothesis supporting a role for fructose, a component of sugar and high fructose corn syrup, and uric acid (a fructose metabolite), in increasing the risk for these behavioral disorders. "We present evidence that fructose, by lowering energy in cells, triggers a foraging response similar to what occurs in starvation," said lead author Richard Johnson, MD, professor at the University of Colorado School of Medicine on the CU Anschutz Medical Campus. Johnson outlines research that shows a foraging response stimulates risk taking, impulsivity, novelty seeking, rapid decision making, and aggressiveness to aid the securing of food as a survival response. Overactivation of this process from excess sugar intake may cause impulsive behavior that could range from ADHD, to bipolar disorder or even aggression.

An Alcoholic Parent Can Affect How a Child's Brain Switches Tasks - Scientific American

The scans showed that individuals without FHA went through a transient period between the game task and the resting state in which some brain regions—frontal, parietal and visual areas, in particular—reconfigured the way in which they communicated with one another. People with FHA experienced fewer changes—even after the researchers controlled for factors such as age, gender, motion in the fMRI scanner, drinking and depression. “It looks like FHA impacts the mental preparation to switch from performing one task to another,” Amico says. “This could be analogous to the process of clearing the cache of your smartphone when you want it to switch faster between apps. The problem is that this ‘cache-clearing process’ might be impaired in brains with family history of alcoholism.”

QuarterWatch™ (includes new data from Quarter 2, 2019) Methotrexate Errors, Trends Among Addictive Drugs, and Underreporting of Serious Events | Institute For Safe Medication Practices

While therapeutic opioid use declined between 2013 and 2017, we observed a substantial increase in prescriptions for amphetamine and methylphenidate products, the other major Schedule II drugs. These potent stimulants of the central nervous system (CNS) increase the release of multiple neurotransmitters, including dopamine and norepinephrine. Despite well documented risks of dependence and addiction, an estimated 7.8 million persons, about 2.4% of the US population, reported taking amphetamine products in 2017. Overall, reported use of amphetamine and methylphenidate products increased by 37% from 2013 to 2017, with the most rapid growth among adults (66% increase) rather than children (14% increase). The changes in exposure are shown in Table 1.

Cycles of reward: New insight into ADHD treatment: Neural processes involved in ADHD -- ScienceDaily

Neurons release dopamine in different ways: phasic release is characterized by quick, high intensity spikes in the neurotransmitter, often in response to motivational stimuli like drugs or sugary treats. Tonic release, on the other hand, refers to slower, more regular firings of dopamine neurons, and is involved in muscle and joint movements. Wickens and his collaborators initially thought that, since methylphenidate blocks the reuptake of dopamine by receptors in the brain, that the drug should increase the phasic dopamine signal. Rather, after analyzing their data, the researchers found the opposite: methylphenidate did not increase phasic dopamine. To explain this finding, Wickens suspects that the brain has a remarkably powerful feedback mechanism to keep the brain's dopamine levels in check, even when reuptake is blocked by methyphenidate. "When you use methylphenidate in the intact brain there's a neural regulation mechanism to compensate for the direct effects of the drug," said Wickens. "Methylphenidate's therapeutic effects could be indirect consequences of this feedback loop." The computer modeling suggests that methylphenidate primarily impacts the tonic dopamine signal. Shifts in tonic dopamine signaling may activate dopamine receptors in ways that improve the symptoms of ADHD.

Or was it the "speed"?

The rates of traffic and moving violations were also significantly higher among young drivers with ADHD as compared to those without ADHD. Among these drivers, nearly 37 percent were issued a traffic violation and nearly 27 percent a moving violation within their first year of driving, compared to 25 percent and 18 percent respectively among their peers without ADHD. Drivers with ADHD had higher rates of alcohol or drug violations and moving violations (including speeding, nonuse of seat belts, and electronic equipment use). Their rate was 3.5 times that of young drivers without ADHD in the first year of driving and 1.5 times that of young drivers without ADHD in the first four years of driving.

First double-blind controlled trial of TNS shows reduced symptoms in some children with ADHD -- ScienceDaily

TNS utilizes a small stimulator worn on a child's clothes to emit a low-level current, powered by a 9-volt battery. Thin wires are connected to the device with an adhesive electrode patch worn across the forehead during sleep. Mild stimulation to the skin, barely or not perceptible to the child, led to activation of deeper brain areas associated with concentration and impulse control. Children wore the patch an average of eight hours nightly and patches were removed each morning. "ADHD is estimated to affect 9.5 percent of school-age children and 4.4 percent of adults," said James McGough, MD, Professor and child psychiatrist at the Jane & Terry Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles, CA, USA. "Our current treatments mostly depend on medication with some role for behavioral therapies. Although there is great demand for non-medication ADHD treatments, the most popular options have minimal, if any, scientific evidence supporting their use."

Genetic risk for ADHD manifest in brain structure in childhood -- ScienceDaily

The analysis showed that morphological differences in the caudate nucleus could, in part, explain the association between genetic risk for ADHD and attention problems in boys; however, this association was not observed in girls. "ADHD is more prevalent among boys than girls and the reasons for this difference are still being investigated," explains Silvia Alemany. "And our findings suggest that the genetic variants associated with ADHD may act differently in the brains of boys and girls."

African-American mothers rate boys higher for ADHD: Maternal race may impact racial differences in ADHD diagnosis more than child race, researchers report -- ScienceDaily

"Differences in ADHD symptom ratings were influenced almost entirely by maternal race."

How attention orchestrates groups of nerve cells to enrich the brain's symphony -- ScienceDaily

Silence in the concert hall. The conductor raises the baton and the strings begin. They play the first four bars of Mozart's "A Little Night Music." All together they play a single melody, which is probably one of the best known in the music world. Then the voices divide. Different string instruments play separate melodies and the "Little Night Music" thus becomes a complex work of art. Scientists from the German Primate Center (DPZ) -- Leibniz Institute for Primate Research in Göttingen and Institute for Research in Fundamental Sciences in Tehran, Iran, recently discovered in a study with rhesus monkeys that nerve cells assume the role of musicians in visual perception in our brain. Usually many cells are active together (synchronously) when they process simple stimuli from our environment. The researchers were able to show that visual attention desynchronizes these nerve cells' activity and thus enables more complex information processing. Such insights into the neural mechanisms of attention in the healthy state may provide evidence of mechanisms underlying neuronal diseases such as attention deficit hyperactivity disorder (ADHD) or autism (BMC Biology).

What you don't look for can't hurt your share price...

Only nine of 185 randomized clinical trials and 23 of 259 non-randomized studies and patient reports of methylphenidate in children and adolescents with ADHD reported assessment of psychotic symptoms.

Study identifies distinct origin of ADHD in children with history of brain injury -- ScienceDaily

The researchers also looked for hallmark abnormalities in brain structure associated with the disorder. The association between volumes of ADHD-related brain structures and ADHD symptom severity was similar between the two groups. However, an analysis of the connections bridging the two brain hemispheres revealed opposite relationships with ADHD symptoms between the groups. The structural findings indicate the presence of both similar and distinct neural mechanisms that cause ADHD after TBI.

ADHD drugs do not improve cognition in healthy college students -- ScienceDaily

Results of the new study, published last month in the journal Pharmacy, show that the standard 30 mg dose of Adderall did improve attention and focus -- a typical result from a stimulant -- but that effect failed to translate to better performance on a battery of neurocognitive tasks that measured short-term memory, reading comprehension and fluency. Weyandt has a theory about why working memory would be adversely affected by the medication. Brain scan research shows that a person with ADHD often has less neural activity in the regions of the brain that control executive function -- working memory, attention, self-control. For people with ADHD, Adderall and similar medications increase activity in those regions and appear to normalize functioning. "If your brain is functioning normally in those regions, the medication is unlikely to have a positive effect on cognition and my actually impair cognition. In other words, you need to have a deficit to benefit from the medicine," Weyandt said. Participants in the study also reported their perceived effects of the drug and its impact on their emotions, with students reporting significant elevation of their mood when taking Adderall. In contrast to the small, mixed effects on cognition, the drug had much larger effects on mood and bodily responses, increasing positive mood, emotional ratings of the drug effect, heart rate and blood pressure. "These are classic effects of psychostimulants," said White. "The fact that we see these effects on positive emotion and cardiovascular activity, in the same individuals for whom cognitive effects were small or negative in direction, is important. It indicates that the cognitive and the emotional impact of these drugs are separate. How you feel under the drug does not necessarily mean that there is an improvement in cognition; there can be a decrease, as seen here in young adults without ADHD."

Therapy dogs effective in reducing symptoms of ADHD, study finds -- ScienceDaily

Results from Schuck's research indicate children with ADHD who received canine assisted intervention (CAI) experienced a reduction in inattention and an improvement in social skills. And, while both CAI and non-CAI interventions were ultimately found to be effective for reducing overall ADHD symptom severity after 12 weeks, the group assisted by therapy dogs fared significantly better with improved attention and social skills at only eight weeks and demonstrated fewer behavioral problems. No significant group differences, however, were reported for hyperactivity and impulsivity. "Our finding that dogs can hasten the treatment response is very meaningful," said Schuck. "In addition, the fact that parents of the children who were in the CAI group reported significantly fewer problem behaviors over time than those treated without therapy dogs is further evidence of the importance of this research."

Nonprescription use of Ritalin linked to adverse side effects, UB study finds - University at Buffalo

“We saw changes in the brain chemistry in ways that are known to have an impact on the reward pathway, locomotor activity, and other behaviors, as well as effects on body weight,” Thanos says. “These changes in brain chemistry were associated with serious concerns such as risk-taking behaviors, disruptions in the sleep/wake cycle and problematic weight loss, as well as resulting in increased activity and anti-anxiety and antidepressive effects.” Further research indicated that female subjects were more sensitive to the behavioral effects of methylphenidate than the males. Thanos hopes that studying the effects of methylphenidate on those without ADHD may lead to a greater understanding of how the drug works on the brain and behavior, and can help researchers understand the impact of the drug on young people throughout development. “Understanding more about the effects of methylphenidate is also important as people with ADHD show greater risk to be diagnosed with a drug dependency problem,” Thanos says. “In addition, this study highlights the potential long-range risks college students take in using Ritalin for a quick study boost.”

Napping and teenage learning

Routine nappers, who napped five to seven days in a week, had sustained attention, better nonverbal reasoning ability and spatial memory. How long to nap is also an important question? The sweet spot is between 30 to 60 minutes. A nap longer than one hour interferes with circadian rhythm. Participants who slept between 30 to 60 minutes produced better accuracy in attention tasks as well as faster speed. She recommends not to nap after 4 p.m., nor over-nap. Researchers were surprised to find a positive relationship between midday napping and nighttime sleep, which is different than the literature. Habitual nappers (who napped more often) tended to have a better nighttime sleep. “That’s different than the findings in the United States, where napping may serve as a function to replace sleep lost from the previous night. Consequently, that may interfere with the following night’s sleep,” Ji said. “In China, a midday nap is considered a healthy lifestyle. Routine nappers are more likely to experience healthy nighttime sleep. So routine nappers are essentially trained to sleep well and sleep more at night.”

Prevalence | ADHD | NCBDDD | CDC

Percent of Youth Aged 4-17 Ever Diagnosed with Attention-Deficit/Hyperactivity Disorder by State: National Survey of Children's Health

Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: the sunny perspective. - PubMed - NCBI

The preventative effect of high SI might be related to an improvement of circadian clock disturbances, which have recently been associated with ADHD. These findings likely apply to a substantial subgroup of ADHD patients and have major implications in our understanding of the etiology and possibly prevention of ADHD by medical professionals, schools, parents, and manufacturers of mobile devices.

The Selling of Attention Deficit Disorder - The New York Times

In an interview last month, Dr. Dodson said he makes a new diagnosis in about 300 patients a year and, because he disagrees with studies showing that many A.D.H.D. children are not impaired as adults, always recommends their taking stimulants for the rest of their lives. He said that concern about abuse and side effects is “incredibly overblown,” and that his longtime work for drug companies does not influence his opinions. He said he received about $2,000 for the 2002 talk for Shire. He earned $45,500 in speaking fees from pharmaceutical companies in 2010 to 2011, according to ProPublica, which tracks such payments. “If people want help, my job is to make sure they get it,” Dr. Dodson said. Regarding people concerned about prescribing physicians being paid by drug companies, he added: “They like a good conspiracy theory. I don’t let it slow me down.”

OCD after three weeks on ADHD drugs – henry copeland – Medium

One boy spent 36 hours playing with legos. Another had a similar experience with video games. Another child spent seven straight hours raking leaves, “after which he still felt compelled to rake individual leaves as they fell.”

Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. - PubMed - NCBI

We analyzed data from 49 randomized, controlled clinical trials in the pediatric development programs for these products. A total of 11 psychosis/mania adverse events occurred during 743 person-years of double-blind treatment with these drugs, and no comparable adverse events occurred in a total of 420 person-years of placebo exposure in the same trials. The rate per 100 person-years in the pooled active drug group was 1.48.

Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

Mosholder et al.21 reviewed and analysed data from the medication manufacturers on ADHD drugs from 49 randomised controlled clinical trials. They identified a total of 11 psychosis/mania adverse events during 743 person-years of follow-up in 5717 individuals (1.48 events per 100 person-years or one event in every 70 years of treatment) compared with none reported with placebo, giving a number needed to harm of 526.

1 in 6 adults getting Adderall experience acute anxiety in 4 months

Acute anxiety symptoms occurred in 4 of 7 patients with a comorbid anxiety diagnosis. CONCLUSION:

Chapter 5—Medical Aspects of Stimulant Use Disorders - Treatment for Stimulant Use Disorders - NCBI Bookshelf

Some researchers and clinicians describe the development of stimulant-induced psychosis as an evolving process. Panel members depicted MA users as having brief and transient psychotic episodes before a full-blown psychosis emerges after more extensive chronic use. MA users often recognize these early psychotic effects and try to stave them off by self-medicating with alcohol or decreasing drug use. In several articles, Ellinwood and colleagues describe the evolution of MA-induced psychosis as progressively abnormal behaviors--beginning at moderately high doses--with intense feelings of curiosity about the environment and patterns of exploration that result, for example, in examining the punctuation periods in a magazine text for evidence of a secret code (Ellinwood et al., 1973).

Ritalin Use in Childhood Has Long-Term Effects on the Brain

The initial scans revealed that the brains of subjects who began taking Ritalin before the age of 16 (the “early treatment” group) had lower levels of GABA — a neurotransmitter linked to inhibition control and often implicated in the neurological makeup of ADHD — than did those who started stimulants later or never took them all. After Ritalin was administered, however, and the patients re-scanned, only the early treatment group saw any increase in GABA levels.