ADHD Medications and Neuroprotection: Further Issues

In this short video I discuss some of the issues that remain to be investigated in the area of increased neuroprotection that arises in association with longer term use of ADHD medications.

[@leilaschafernak-perez8814]

Thank you for this information! Ever since watching your popular near 3-hour lecture about 30 things parents with ADHD kids should know, I’ve gotten to know and accept myself more, despite being 20 years old. Love the truly science/academic-driven videos you post. Thank you for your immense contribution to science and knowledge about this disorder. You’re heaven sent!

[@russellbarkleyphd2023]

I am so glad it was helpful to you. It’s an older video but still informative for many people. Thanks!

[@franceskaschaeuffele64]

Could you please link to the Video you mentioned?

[@johannesmulleraguilar9495]

If anyone is struggling to find a topic for their neuropsychology dissertation, this video serves as an excellent foundation for a study. Thank you for your videos, Dr. Barkley

[@tayzonday]

I feel this vividly with medication. My IQ tests 96th percentile unmedicated (largely due to being 30th percentile in processing speed)- and being on 40mg Vyvanse with 75mg Bupropion makes me feel much “smarter” and higher functioning. However, Vyvanse by itself can feel counterproductive if I’m on no other meds. I’d be curious to see my exact med combination in this same type of study.

[@ehllowpr8049]

And I've still got PTSD from chocolate rain. Don't think any amount of medication will help me

[@prosp6070]

This is familiar for me, I had a very similar experience.

[@joelwilliams3115]

How did the buproprion help? We don’t have that as an option in Australia, it’s only prescribed for smoking cessation. But I like the idea of combining stimulants with 24/7 lasting meds like that or atomoxetine

[@tayzonday]

@@joelwilliams3115 I truly am a “sometimes verbal” autistic. I experience sensory overload in the form of synesthesia (one sense triggering others) and dysregulation or magnitude in the form of hyperacusis, misophonia and hapephobia- extreme neurological sensitivity and involuntary fear/pain response to sound and touch in layperson’s terms. These things can shut my brain down entirely and render me nonverbal. If I only medicate with a stimulant like Vyvanse, the lifelong cognitive behavioral adjustments I’ve made to mask in society will sometimes have their maladaptive peak performance amplified. I need bupropion to tone down my neurological synesthesia, hyperacusis, misophonia and haphephobia to give Vyvanse a chance to amplify helpful aptitudes rather than maladaptive ones.

[@prosp6070]

@@joelwilliams3115 I can't speak for the poster, but I am in a situation where I have ADHD, and them a large portion of the ASD symptom list but here not enough to get an official diagnoses, the result is, Stimulants are over stimulating. I have tried non-stims, but they murder you... sex drive so.. that is a no go for me. Honestly, its been great! I can focus, but it doesn't kill my creativity, I don't feel like I am in a box. But I also don't take it alone. I do take neurotransmitter supplements, and I did so before I got on the meds, and they helped quite a bit with enough fiber too. This specific med has a very subtle effect across many areas so its like elevating everything at the same time, but it doesn't do much elevating in of itself If that makes sense

[@insidiatori9148]

We love you Barkley! WE DO!! We love you Barkley! WE DO!! We love you Barkley! We DO!! Ooooh Barkley we love you!!!

[@russellbarkleyphd2023]

Wow. I am deeply touched by your kindness. Thanks!

[@ColinTimmins]

Thank you for these weekly updates Dr. Barkley. For what’s it’s worth, I’ve been on ADHD a only a few months now and I don’t feel quite so old. I’m almost 46 now but I felt that I was mentally older then that. My cognitive decline over the last couple of years had me very concerned. Let’s hope I continue my recovery. =]

[@Issy2226-c6p]

Thank you, Dr Barkley. Fascinating.

[@jlaustill]

I'm 43 and was diagnosed only a couple of months ago. These videos are truly amazing for me, and I appreciate you taking the time to make and post them. I'm just starting month 3 with Adderall and I can't even believe the difference it makes in my ability to sit still, concentrate, and regulate my emotions. Even after taking it this long it still amazes me that a stimulant helps me sit still

[@birtedg2869]

Thank you so much for these clarifications which seem very important if we consider individual decisions for or against medication. I also need to thank you for your whole channel! At least in my country there are many prejudices which hinder adequate treatment. Maybe I would never have tried ADHD medication without all the things I learned in your videos. And medication as well as all the knowledge were a life changer for me as a late diagnosed parent and my kids! So thank you for these calm and well-founded insights into ADHD research.

[@cyristalc]

I found one of your talks when I was just 12 years old. I was such a lost child severely punished by the school system about to fail 7th grade until they diagnosed me with ADHD. I didn’t receive proper treatment until this year at 24. Dr. Russell Barkley your dedication to helping neurodivergent people will forever be unmatched. I will always remember when I was 12 staring at the computer hearing you describe ADHD as being “a myopia to the future”. I will never forget that and just wanted to say thank you so much…

[@cyristalc]

You are one of the only doctors that knows how serious of a disorder ADHD is and to this day I am still so impressed by your commitment to the community.

[@russellbarkleyphd2023]

Thanks ever so much. That was very kind of you to let me know about how my work has been of help to you. Be well.

[@themobbit9061]

Thank you for elaborating on this. It’s good news and I’ve sent it to clients

[@Handle8844]

TIME TO OPEN THE BOTTLE, Dr. B! 🥳🎉🍷 Congratulations to you and your LLC (because we know that behind many a great content-maker, there is a supportive, patient partner) on reaching 100,000 subscribers. 💙💙💙💙💙

[@russellbarkleyphd2023]

Yes, indeed. Tonight with Gabriele and some family. Thanks so much!

[@gabriellawaldi]

I hope a scientist is watching and researches it. Thank you Dr. B.!

[@sonyaparkin7841]

Blessings to you Dr. Barkley 😍🥰🙏🙏🙏💛 thank you for the work you do

[@thinktank4383]

Thanks Dr Barkley.

[@BenRichterTU]

Another question I'm curious about - Among those with brain volume increases, are these gains maintained if the individual stops taking the medication? PS, if you're looking for another topic to cover, I'd be very curious to hear your thoughts on the role of executive functions in dyslexia! Thanks, as always, Dr Barkley.

[@russellbarkleyphd2023]

Very good question. We don’t know.

[@marcellusgr]

You are the 🐐

[@publius9350]

Oh, man - all the questions I wanted to ask, and unfortunately the answers just seem to be that we don't know. Love your channel as always, glad to see you hit 100 k, and I'll be around for the next 100 k!

[@Jofferpg2009]

Precise and clear as always. Tks professor!

[@EnsignEpic]

Definitely needs to be more studies into whether or not this effect is visible in more non-stimulants. If this effect is seen in them as well, it would suggest that the neuroprotective effects are not a property of any individual medication themselves, so much as an effect of their effects on attention giving a needed assist to those portions of the brain that are smaller in the ADHD population. Basically the idea is that those already-smaller attention areas are already under so much stress from the demands of trying to keep up, they're in survival move; but the moment that those attention systems are given some form of assist, regardless of what chemical (or heck, even intervention in general, if we wanna push the research potential further) provides that assist, they are no longer in survival mode & are able to dedicate the resources towards further development in a manner similar to how they would develop in the neurotypical population. Which in turn produces a positive feedback loop towards increasing attention in general, which would explain why some folks who receive early medical intervention no longer qualify for diagnosis later in life - the medication helped to offset any deficit of those smaller areas of the brain, allowing them to develop in a more typical fashion when compared to the chronically-stressed areas of their unmedicated peers. And the best part is, this idea definitely has solid basing in other related research as well. We know people pay better attention when they're under less (dis)stress. We know people learn better when they're under less stress. We know these medications improve outcomes by improving attention in various ways. Just gotta tie them all together in a neat little research package.

[@SteelmanArgument]

First off, thank you Russell for your down to earth attitude and genuine compassion for us with ADHD. It shines through in your content and communication. Even though you don’t sugar coat anything and go straight to the point. I love it! Would you please talk about the relatively new study “Attention deficits linked with proclivity to explore while foraging” from 2024? I’d love to hear your reflections/rebbuttal or whatever you have to say about it! Thanks! 🙏

[@russellbarkleyphd2023]

You are most welcome. I did a video in the foraging study under the Breakin News playlist as I recall. The study used a simple foraging video game that has no ecological validity in terms of predicting anything in real life.

[@MeadowgreenStudio]

Interesting. Thank you.

[@iliyanovslounge]

So close to 100k!!! :)

[@P.08]

Thank you Dr.Barkley I've recently found your channel, and it's helped alot in understanding myself. Can I ask what do you think about Bupropion for adult adhd please? Am 30 yo but am hesitant about stimulants because of my addictive personality traits. I've started Bupropion recently but can't seem to notice much

[@russellbarkleyphd2023]

It’s helpful according to some research even though unapproved for ADHD. So it has to be used off label by physicians which is not a problem here.

[@lisagamble6503]

Is there any research investigating adhd exposure to meducation over time. With individuals also living with TBI's ? There is growing evidence that early childhood TBI's may have longer lasting impacts on brain development. It may complicate the adhd presdntation. An the effect the responsiveness of the patients to medication.

[@publius9350]

Also wondering on this! Stimulants have use for TBI, even when not diagnosed with ADHD. I had a car accident that likely made everything ADHD related far more.

[@forisma]

So interesting.

[@matthewfearon]

Dr. B! I’d be very interested if there’s any studies on creatine monohydrate and ADHD. I’ve started taking 5g a day (for working out) but I’ve heard it may have cognitive benefits especially for working memory. Side notes, I’m also on trt, post cancer - which definitely helps cognitively on top of my Elvanse (Vyvanse). On another side note I’ve also taken up a Mediterranean Diet…can’t remember if I’ve already posted that, due to the study in one of your last videos. Still staying plant based though to keep Cholesterol levels under control due to all these potential cardiovascular harming meds I’m on, particularly testosterone.

[@djorankeil]

I just found out about "Intrusive Sleep" which is apparently common to ADHD'ers. I don't know where else to ask this so I'm asking here if you know anything about it as I'm having difficulty finding good information. I've had something that sounds pretty much exactly like this ever since I can remember. Basically being 'bored' into unconsciousness, especially when forcing myself to focus on something I don't find intrinsically engaging, like working on an essay or reading articles. I can go from fully awake to barely cognisant and having to take a nap incredibly quickly.

[@colbyboucher6391]

Interesting. I've always had a hunch that medication can get someone to a place where they can "solidify" it's changes with some work (where without the medication they wouldn't be able to establish the right habits in the first place).

[@zhivango]

My academic performance has been terrible lately, if there's anyone who can help I'm down, please comment via this and I look forward to talk with you lovely people. Peace :)

[@jaeshasway]

Probably best to reach out to your doctor.

[@joelwilliams3115]

Hi Dr Barkley. Would you be able to make a video focusing on the benefits/drawbacks of medication tolerance breaks? My psych wants me to take a week off Vyvanse occasionally to reset my tolerance, give my heart a break (I don’t have underlying heart issues, she’s just being cautious) etc… but I don’t like being off my medication. I hate when my adhd symptoms return. Yet, I do notice the medication losing effectiveness when I use it every day for months in a row. It’s just a shame stimulants work this way… any advice or evidence you could offer would be appreciated. Thanks

[@human-ft3wk]

Quick question about CDS & ADHD at the same time. If ADHD has impulsivity and CDS has almost a negative correlation with impulsivity: how could both co-exist at the same time? Is it just a matter of saying this person struggles with the other 6 EF skills, just not impulsivity?

[@iliyanovslounge]

From my understanding, the symptoms would fluctuate from one to the other disorder depending on context. So while the inhibition EF deficit (which underlies the symptoms of hyperactivity-impulsivity, perseveration, and to some extent, emotional dysregulation and distractibility) may appear negatively associated with CDS it could be contextual. In order words, perhaps the EF itself is not oppositely developed if CDS is present, but other brain regions implicated could promote more inhibition in certain circumstances while the EF remains natively deficient too if ADHD is present.

[@russellbarkleyphd2023]

The correlation may be negative but small even if significant which allows for substantial variation in this relationship within the groups that were studied. So it doesn’t mean they can go together but that across the group they tend not to occur as often together as in nonCDS groups. Be well.

[@human-ft3wk]

@@russellbarkleyphd2023 Thank you for your answer. If I understood correctly that means that one can have CDS and ADHD and have high impulsivity at the same time, but they'd represent an outlier when looking at just the CDS group. They as a group tend to have less impulsivity, it doesn't mean each individual with CDS has low impulsivity. I'm thinking about this since I don't know if I have ADHD or CDS or both, I'm a bit confused. I definitely have had significant issues with getting things done, literally done my homework about 4 times in all 4 years of high-school. Failed half my modules in first 2 years of university because of just not doing the work in spite of wanting to. I do seem to have very bad EF skills, as I definitely struggle with persisting and have quite poor working memory. But CDS describes me to a T and I definitely don't present with any impulsivity. My mom and brother are almost picture perfect classic ADHD cases, so due to the genetic component of it, I wonder if I have it too combined with CDS (without getting in the weeds, was consistently given a hard time in childhood and I was the younger child, very dangerous environment). Best thing to do is get evaluated by a professional but given the newness of the disorder, and its omission from DSM I doubt there's anyone in my area who would be able to.

[@jordankaangelova]

Hi Dr. Barkley. I’m a medical doctor and my 6 year old son was just prescribed Biphentin 10 mg po qd for ADHD. I had to stop it because his emotional lability and aggression increased. Is there a way we can connect to discuss? I have such limited knowledge regarding stimulant use in children. I would appreciate your input.

[@antes4586]

Does Stratera(atomoxetine) increase brain volume

[@stevetv2023]

Hi Dr. Barkley QUESTION(S): Have the neuroprotective healing benefits (with understanding that not all people experience the benefits) and regional brain volume growth observed in some cases for people on stimulant medication been recorded for patients of all ages, or is there some benefit weighting factor/scale based on age? Is the age a patient is diagnosed and started on stimulant meds a significant factor in a) likelihood of neuroprotective healing benefits occurring, and b) overall scale of brain region healing and the potential for partial or full shift towards neurotypical diagnosis? I acknowledge there are several caveats and need for further research, but based on what you’ve read/know so far, do you have enough data to comment? Many thanks and keep up the great work! 🙏🏻👏🏻👏🏻

[@sonyaparkin7841]

💚🙏

[@kerrissedai6857]

So when I was in 2nd grade I was diagnosed with asthma and started taking theophylline. I wondered if had any affect on my ADHD. Somewhere around 5th grade things started clicking for me academically.

[@jaeespo5413]

I had 2 adhd/EF coaches and 6 therapists to work with my daughter who is now 19. She just finished her freshman year at college and struggled. She had serviced in place for support. You have mentioned cbt doesn’t work. I am beyond overwhelmed at this point. I believe I was never diagnosed as a child as well as he father. Any contacts you can share?

[@jaeminko4286]

Medications?

[@gdtoob]

Do these benefits extend to patients who start taking the medicine during adulthood?

[@LA-lw7xy]

Hi, which medications are you referring to?

[@lisagamble6503]

My last question, last weeks MRI's, were they just children's brains that had such significant development potential of up to 75%. Or did it include brain scans of adults treated over 7-10years.? I just wanted to know if adult neuroplasticity could be capable of such a significant change (if, however, achieved more slowly). Context Last week you presented MRI's showing the brain volume growth in the regions effected by adhd of patients on medication for a number of years. The results seemed to show a potential of a 75% increase in brain volume development. This being contrasted to the adhd control group not treated with medication, demonstrating lack of development in specific areas. It was very impressive evidence.

[@user-fu4gq2wp1k]

ADHD with Anxiety and mild Depression, For adult, as a student and mother What is your recommendation for the best medication please

[@youbewb5581]

Dr. Carl Hart has entered the chat.

[@lisagamble6503]

The original estimate is that of the children and adolescents who are diagnosed. Only one-third will continue to have identifiable adhd in adulthood. Is that false then?. If you're saying that, only 14% of them actually outgrow it. One would assume that the 14% are the highly intelligent group (as it has been identified that high IQ does seem to give some protection). That this group, therefore, is likely to be only originally mildly impacted in their daily lives. "High functioning adhd". I mean, no one (children/ adolescent) out grows moderate or severe adhd, naturally do they ?. They often get good at masking it and if given a bit of support not known to everyone it seems like their managing alone. Or does this evidence suggest that moderate and severe levels of impact can now be overcome by 2-7years of medically prescribed medication. Or is it that the medication can reduce to normal for the moderate group (25-40% high functioning adhd group), and just reduce symptoms of the severe group. Or that the severe group and some moderately affected individuals aren't as responsive to the medication. Being the other 60%. Sorry, I hadn't meant to ask so many questions.

[@jaeminko4286]

Higher intelligence seems to compensate ADHD impairments at least academically. But once they move out, needs to file their taxes & find a job and manage their own schedule, that’s when the executive functioning really starts to emerge..

[@lisagamble6503]

In the interests of reducing meducation doasge once you establish greater brain volume in the adhd brain of moderate and severe: Of the 60% who are not responsive enough, to the adhd medication, to permanently structurally change their brain volume. Would giving that group especially, the guidance of 30-40mins of daily stress reduction meditation. Over a 8-12 period, allow for the beginnings of structural development for them? It has been evidenced for a random group. Through MRI's that this can cause signifcant brain structural changes, and increase regional activation, so I would assume its also triggering increased nuerochemicals. Though unknown if any of the participants had neurodiversity.

[@salparadise1220]

I wonder what effect hallucinogens have? Because it's permanent, as far as I can see. And Im still getting better results from Lion'sMane Mushroom extract than from lisdexamfetamine. I wonder if there's any effect there? (Only been on them for a few weeks, so, early days.)

[@rappar9673]

I rather deal with my mind over dealing with the side effects of these drugs. You have to understand that if you lived in tropical equatorial africa as a forager-gatherer, you'd be a perfectly functional individual. The problem isn't ADHD, it's this productivity-obsessed society we built that forced us into being misfits. Taking drugs is a patch, the basal problem must be addressed, not our minds.

[@jaeminko4286]

The problem is Adhd. The side effects of unmedicated ADHD vastly outweigh side effects of stimulants, which are usually benign to begin with.

[@rappar9673]

@@jaeminko4286 No matter how many videos I watch about it, or articles I read on the matter, I'm not convinced.

[@jaeminko4286]

@@rappar9673 Not sure why you are saying so. 3 times more likely to get into a car accident, way more likely to engage in risky sexual behavior, obesity & almost 40% substance abuse, interpersonal difficulties, career underachievement….

[@rappar9673]

@@jaeminko4286 50 years alive and so far so good, but thanks for your concern.