Prescription Stimulants Decrease Productivity in Neurotypical People
Participants without ADHD who took methylphenidate took 50% longer to finish a cognitive task compared to those who were not given prescription stimulants, a new study finds.
June 25, 2023
Prescription stimulants such as Adderall (amphetamine/dextroamphetamine salts) and Ritalin (methylphenidate) decrease productivity in people who do not have attention deficit hyperactivity disorder (ADHD), according to a new study published in ScienceAdvances.1
In the randomized, double-blinded, placebo-controlled study, 40 neurotypical adults, ages 18 to 35, were given either 30mg of methylphenidate, 15mg of dextroamphetamine, 200mg of modafinil, or a placebo, before being asked to solve a complex cognitive challenge that was representative of a real-life task. The researchers found large increases in effort and time spent to solve the problem but decreased efficiency and accuracy among study participants on stimulants compared with those given a placebo.
Further, participants who performed at a high level under placebo conditions tended to exhibit larger decreases in performance and productivity after receiving the stimulant. On average, participants who were given methylphenidate took 50% longer to finish the task compared to the placebo group.
“Our research shows drugs that are expected to improve cognitive performance may actually be leading to healthy users working harder while producing a lower quality of work in a longer amount of time,” says Dr. Elizabeth Bowman, lead author of the study and researcher at the Centre for Brain, Mind and Markets at the University of Melbourne in Australia.
Prescription Stimulants Misuse
These study’s findings challenge the popular belief among high-school and college-aged students that stimulants work as “academic steroids” to boost performance, even in those without ADHD.2
According to research published in the journal JAMA Network Open, 1 in 4 middle and high students misuse prescription stimulant medication. The study found that non-medical use of prescription stimulants among teens is more prevalent than misuse of other prescription drugs, including opioids and benzodiazepines.3 Researchers also discovered that more than half (54%) of college students and a quarter of high school students are approached by their peers who ask them to divert their prescribed stimulants.4,5
The potential consequences of prescription stimulant abuse include depression, anxiety, seizures, overdoses, psychosis, cardiovascular conditions, and stimulant use disorder. The consequences of using counterfeit stimulants — obtained by teens through social media referrals and online drug markets — are even more dire, as demonstrated by the tragic death of two Ohio State students last year from counterfeit stimulant medication laced with synthetic opioid.
In a blog post for ADDitude, Edward Hallowell, M.D., likened stimulant use to wearing eyeglasses. “Without your glasses, your execution of everything suffers,” he explained. “You go about your day making mistakes, bumping into things, risking getting fired because suddenly you’re incompetent.”
Findings from the ScienceAdvances study suggest this metaphor is apt. Just as eyeglasses reduce, rather than heighten, clarity for those with no acuity issues, stimulants decrease productivity and efficiency in those seeking a performance boost rather than treatment.
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1Bowman, E. et al. (2023). Not so Smart? “Smart” Drugs Increase the Level but Decrease the Quality of Cognitive Effort. Sci. Adv. DOI:10.1126/sci-adv.add4165
2Benson, K., Flory, K., Humphreys, K.L., Lee, S.S. (2025). Misuse of Stimulant Medication Among College Students: A Comprehensive Review and Meta-analysis. Clinical Child and Family Psychology Review.
3McCabe, S.E., Schulenberg, J.E., Wilens, T.E., Schepis, T.S., McCabe, V.V., and Veliz, P.T. (2023). Prescription Stimulant Medical and Nonmedical Use Among US Secondary School Students, 2005 to 2020. JAMA Netw Open. (4):e238707. doi:10.1001/jamanetworkopen.2023.8707
4McCabe, S.E., Teter, C.J., and Boyd C.J. (2006). Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs. J Am Coll Health. 54(5):269-278. https://doi.org/10.3200/JACH.54.5.269-278
5McCabe, S.E., West, B.T., Teter, C.J., Ross-Durow, P., Young, A., and Boyd, C.J. (2011). Characteristics Associated with the Diversion of Controlled Medications Among Adolescents. Drug Alcohol Depend. 118(2-3):452-458. https://doi.org/10.1016/j.drugalcdep.2011.05.004