The stimulants improve brain oxygenation and decrease the damage caused by oxygen free radicals in the brain. There is some evidence to suggest that children who take stimulants to treat their ADHD symptoms perform better academically and later in their schooling than kids who are not treated with stimulants. The long term affects of stimulant use with regards to future life outcome measures (such as being gainfully employed as adults, succeeding in college, etc) has not been researched extensively.
There are no long term studies comparing stimulant treatment to other forms of treatment such as behavioral therapy, cognitive therapy, supplement therapy, or other interventions but there are at least a few studies that have looked at kids over a 10 year period and concluded that the children that were treated with stimulant therapy achieved better academic results, later in life, than the kids that never received treatment.
The likely biological reason for the improvement in this academic success in youngsters who have been treated with stimulants relates to the stimulant’s ability to improve the brain’s use of oxygen. ADHD Medication act to reduce the oxidative stress on the brain. Several psychiatric and neurological illnesses including schizophrenia and Parkinson's disease have been associated with unfavorable levels of brain oxygen free radicals. It is thought that these oxygen free radicals cause brain DNA damage that, in turn, causes psychiatric and neurologic symptoms.
A study published recently in the Journal of Neural Transmission found that Strattera, the Ritalin (methyphenidate) and the Adderall (amphetamine) family of medications, in the laboratory, can act to significantly decrease an enzyme that indicates high Brain DNA oxidative stress. The authors conclude that Ritalin, Adderall and Strattera help ADHD, at least in part, by decreasing free radical damage to the brain's DNA.
Having a biological basis for the improved outcome seen in people treated, long term, with ADHD medication is important. Many parents and patients, concerned regarding the long term harm that might result from being treated with ADHD medications, may be surprised by these findings as this new information points to just the opposite conclusion, that there may be long term benefits from ADHD medication treatment.
As there are no comparison studies, we do not know if other therapies also decrease the brain's oxidative stress and improve later outcomes for ADHD. Therapies with flavanoids such as Quercetin and Resveratrol have been also shown to decrease oxidative stress in the brain. Other anti-oxidants that have been shown in studies to improve brain function include coenzyme Q10, Ginseng, Ginko-Biloba and dark skinned berries such as cherries and blueberries.
Vitamins may act as anti-oxidants as well. Vitamins C and E, the B vitamins, the Omega-3 fatty acids and zinc have been found to increase cognitive functioning and this may be partly the result of the vitamin's anti-oxidant action. Iron is necessary for proper brain functioning and is an important component of healthy oxygen levels in the brain and has been strongly associated with improved cognitive functioning in people with ADHD.
Supplements such a phosphatidylserine, lemon balm, Bacopa monnieri and vinpocetine may all improve cognitive functioning and may all do so by improving brain oxygenation and by directly or indirectly decreasing the oxygen free radical brain injury.
Stimulants may help the long term outcome of people with ADHD by decreasing oxygen free radical damage to the brain’s DNA. Other therapies may also help but have yet to be studied. Further research on the outcome of ADHD using various treatment measures is necessary to fully evaluate the risks and benefits of long term stimulant use for ADHD.
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