Stimulierende ADHS-Medikamente beeinflussen nicht, wie bisher angenommen, die aufmerksamkeitskontrollierenden Regionen des Gehirns. Neue Studie zeigt zum ersten Mal, dass diese Medikamente hauptsächlich auf die Belohnungs- und Wachheitszentren des Gehirns wirken und nicht auf seine Aufmerksamkeitsschaltkreise.
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Interesting shift in perspective. This suggests stimulants may enhance task engagement via arousal and reward networks rather than directly modifying attention circuits, which could explain mixed cognitive effects across individuals.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:
https://www.cell.com/cell/fulltext/S0092-8674(25)01373-X
From the linked article:
**Stimulant ADHD medications** work differently than thought
WashU Medicine **researchers find stimulant medications don’t affect attention-controlling regions of the brain, as previously thought**. Brain scans show the drugs affect brain areas involved in wakefulness and reward, highlighted in yellow and orange above.
Prescription stimulants, such as Ritalin and Adderall, are widely used to treat attention deficit hyperactivity disorder (ADHD), including in children. In the U.S., about 3.5 million kids ages 3 to 17 take an ADHD medication, a number that has increased as more children have been diagnosed with the neurodevelopmental disorder.
Stimulant medications have long been thought to treat ADHD by acting upon regions of the brain that control attention, but a new study by researchers at Washington University School of Medicine in St. Louis casts doubt on that thinking. Led by Benjamin Kay, MD, PhD, an assistant professor of neurology, and Nico U. Dosenbach, MD, PhD, the David M. & Tracy S. Holtzman Professor of Neurology, it **shows for the first time that these drugs act primarily on the brain’s reward and wakefulness centers, rather than on its attention circuitry.**
The findings, published Dec. 24 in Cell, suggest that prescription stimulants enhance performance by making individuals with ADHD more alert and interested in tasks, rather than directly improving their ability to focus. The researchers also found that stimulant medications produced patterns of brain activity that mimicked the effect of good sleep, negating the effects of sleep deprivation on brain activity.
“Essentially, we found that stimulants pre-reward our brains and allow us to keep working at things that wouldn’t normally hold our interest — like our least favorite class in school, for example,” Dosenbach said. In other words, the study findings suggest that rather than “lighting up” the attention centers of a child with ADHD, stimulant drugs work by helping make activities that the child normally struggles to focus on feel relatively more rewarding, he noted. That extra motivation helps kids continue challenging activities as well as tedious tasks.
“These results also provide a potential explanation for how stimulants treat hyperactivity, which previously seemed paradoxical,” Dosenbach added. “Whatever kids can’t focus on — those tasks that make them fidgety — are tasks that they find unrewarding. On a stimulant, they can sit still better because they’re not getting up to find something better to do.”
Despite their significant effects on brain activity, the researchers found that stimulant medications were not associated with cognitive gains in all children taking them. Children who got less than the recommended nine or more hours of sleep per night and took a stimulant received better grades in school than did kids who got insufficient sleep and did not take a stimulant. However, stimulants did not correspond with improved performance for neurotypical kids who got sufficient sleep. (It is not clear why these kids were taking stimulant medications.) That is, stimulants were linked with improved cognitive performance only for participants with ADHD or those who got insufficient sleep.
“We saw that if a participant didn’t sleep enough, but they took a stimulant, the brain signature of insufficient sleep was erased, as were the associated behavioral and cognitive decrements,” Dosenbach said.
They’ve known this for years right? Like, it’s always been known stimulants interact extensively with dopaminergic pathways. I will admit I didn’t read the article.
I know a number of people who have been on several different medications for adhd. I also know a number of people who take those drugs recreationally.
Every single one of them is aware of this. Interesting that we only now know it via official scientific evidence
It’s like a scientist went „Hmmm it looks like people keep taking this drug because it makes them feel good and keeps them awake but none of them have specific direct improvements to their attention span – just a more clear head so they can focus… I wonder if there’s something to this“, and now we know.
I thought this was the intent of stimulants? The problem with ADHD is that normal, “boring” things don’t give us dopamine. Including paying attention. Stimulants make pretty much everything give you dopamine, and now paying attention is more rewarding.
Well… This perfectly falls in line with what I tell people about my experience with Vyvanse/Elvanse and many others experience too.
Without them I’m useless. Super lethargic. Unable to stay awake for most of the day and seeking constant stimulation and dopamine. More awake towards the end of the day as a result.
On the meds, in the beginning I finally felt „normal“. Everything seemed balanced. Lasted close to 2 years.
And now… nothing. The meds help me stay awake. Still sleepy but not as sleepy the whole day like before being medicated. And whatever task I’m doing when they kick… that’s all my brain will want to do and hyperfocus on while they are working.
But they don’t seem to help anymore with racing thoughts, executive dysfunction, motivation (for other tasks), energy/momentum and others… (even on differing doses, be it lower or higher).
So the awakeness and staying on task they mention is exactly what I feel while on the meds.
But my bigger struggles were things the meds helped with in the past but don’t anymore – executive dysfunction/task switching and energy/motivation.
Is this really new?! As an adhd person, I’ve been well aware that it’s the rewards centre of my brain that’s different for a long time. That’s how adhd works
i mean…yeah. all you have to do is try them to know this. they don’t do much for focus/attention
Prescribed for TRD not ADHD but I can say I’ve always only noticed a wakefulness effect from it. If anything, it makes my attention span much much worse at times.
SNRI’s people. After 20 years and every stimulant drug in the market, switching to SNRIs changed my life drastically
Which, downstream, affects which kind of circuits in the brain again?
This is interesting, and it relates to what we have been hearing regarding GLP-1 drugs also helping curtail ADHD symptoms.
Could this mean that GLP-1 drugs are a viable alternative to treat ADHD when a person does not respond well to stimulants?
i think nobody actually thought it helped with focus. ADHD is a motivation disorder tied to dopamine, so boosting dopamine helps with motivation and helps with ADHD. Ive been taking meds for ADHD for 10 years and my doctor and psychologist both described it like this from the beginning.
Is anyone here actually looking at that paper? The control is 5 healthy adults, loaded with 40mg methylphenidate before going in that scanner… why this got published as is blows my mind… all those results are comparative. The voxels that light up for those healthy adults is what is guiding the search in the kids group. I have no idea why anyone would promote this study as is…
I’m curious as to why such a broad term as ’stimulants‘ (plural) was used in this study, when it seems only methylphenidate and psilocybin was used in their trial. The difference in the pharmacology between methylphenidate and (lisdex/dextro)amphetamine is significant, isn’t it?
Pretty sure you could have asked any ADHDer and they would have told you that. At least it’s my experience. My main issue is reward dysfunction meaning almost nothing feels worth doing, and stimulants make it easier to care and enjoy things. My thoughts are still very scattered and distractibility doesn’t go down much, but that’s how I like it because otherwise I’d feel too unlike myself