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Childhood Ritalin Use May Have Long-Term Effects on the Brain

A new study finds that levels of the neurotransmitter GABA may be lower in the brains of adults who started taking methylphenidate as children.




September 8, 2017

Stimulant medications used to treat ADHD, like Ritalin and Adderall, have been extensively studied and found to be safe — in the short-term. For the most part, however, their long-term effects on the human brain are not well understood.

A small new study may shed some light on how persistent stimulant use changes the brain. It finds that adults who started a medication regimen during childhood have different levels of certain neurotransmitters — and a different reaction to subsequent doses of Ritalin — than do those patients who began treatment as adults.

The study, published in June in NeuroImage: Clinical, looked at 44 male patients with ADHD, all between the ages of 23 and 40. The subjects were divided into three groups: those who started taking Ritalin (the brand name of methylphenidate) before the age of 16; those who first took Ritalin after the age of 23; and those who had never taken stimulants to treat their ADHD symptoms. All participants underwent baseline brain scans; some subjects from all three groups were later administered a dose of Ritalin and scanned again.

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.

The implications of these varying GABA levels are not quite clear as of yet, but the researchers note that use of methylphenidate early in life — while the brain is in the process of developing — appears to have concrete and lasting neurological effects. Methylphenidate use also appears to affect patients’ brains in different ways in the short term, depending on when treatment was first initiated — as seen in the increased levels of GABA shortly after the drug was administered.

“The results from our study suggest that stimulants have different effects when acting on the developing or the mature brain,” the authors write. “Future studies are therefore warranted to assess the underlying mechanisms, as well as the consequences of these lower GABA+ levels on cognitive and behavioral problems in ADHD.”

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  1. While this is interesting, I wonder if there’s really any point to it. If the GABA increased after another dose of Ritalin, then what’s the problem? The kid just keeps taking it as an adult.

    Maybe it’s different for other people, but for my son, ADHD is a completely life altering disorder. His abilities on and off medication vary dramatically. I could no more take away his medication than I could take away his glasses, less in fact.

    Or maybe I’m just immune to small worries about tomorrow when there are big problems today. My son had to take inhaled steroids for most of his infancy and early childhood because his asthma is so bad. There are many potential long term consequences to that, including being perhaps half and inch, to an inch shorter in his adult height than he otherwise might have been. On the other hand, without the medication he probably would have died before age 5. So.. you know.. trade-offs and all.

    We tried all of the non-medication options with my son, and continued with many of them even after he started taking medication. I suppose in children where they really can be completely treated with non-medication options, this might matter. But the stigma around medication is already so high, I would hate for a child who needs it to not be given it because it might mean he takes it the rest of his life. Lots of people have to take medication all their lives.

  2. Oh, and I also noted that this didn’t seem to control for the severity of ADHD symptoms in childhood or adulthood. We all know there’s a spectrum. You’d really have to do a longitudinal study and compare the level of GABA that the kids had BEFORE they started taking the medication. Maybe kids who are more severe, and thus more likely to get medication early, naturally have lower levels of GABA anyway.

  3. Couldn’t agree with you more about the beed. Now evidenced by this study for a longtitudanal study. My son started raking Ritalin at age 8 after the school threatened to refuse to let him attend class unless he was medicated. We like you tried everything before finally agreeing during the week and school year. This was the 1970s and Feingold ,he of the Red Dye and all sorts of food allergy solutions was the rage…and indeed we did try some on that diet. Never occurred that I as a parent also could also be ADHD combined until 40 years later.
    My son definitely still has rage issues as I often did and is trying to work this out without Meds through help at the large airline he works for. .so I suspect anecdotally he is low on GABA
    My parents started me on coffee at the age of two as i refused to take milk any other way . It was probably half coffee and half milk but by the time i was 10 it was a full thermos an a mod amount of milk.in my last fifteen work years I drank a minimum of 2.5 Qurts/ Litres a day and many days over 3..
    when I switched to Decaf 1 cup a day and Ven la Faxine XR my inhibition control lapsed and i found myself far more outspoken and not in a good way than previously. This has continued to worsen for the 2.5 years that I have been taking it. Is there a relationship between this study and my results even though the stimulant was Caffeine. In many other ways there has been excellent improvement in memory, attitude, and especially life enjoyment. So i would not give this regime up for any reason.

  4. Couldn’t agree with you more about the need now evidenced by this study for a longtitudanal study. My son started taking Ritalin at age 8 after the school threatened to refuse to let him attend class unless he was medicated. We like you, tried everything before finally agreeing during the week and school year. This was the 1970s and Feingold ,he of the Red Dye and all sorts of food allergy solutions was the rage…and indeed we did try some on that diet. Never occurred that I as a parent aazcould also be ADHD combined until 40 years later.
    My son definitely still has rage issues as I often did and is trying to work this out without Meds through help at the large airline he works for. .so I suspect anecdotally he is low on GABA
    My parents started me on coffee at the age of two as i refused to take milk any other way . It was probably half coffee and half milk but by the time i was 10 it was a full thermos an a mod amount of milk.in my last fifteen work years I drank a minimum of 2.5 Qurts/ Litres a day and many days over 3..
    when I switched to Decaf 1 cup a day and Ven la Faxine XR my inhibition control lapsed and i found myself far more outspoken and not in a good way than previously. This has continued to worsen for the 2.5 years that I have been taking it. Is there a relationship between this study and my results even though the stimulant was Caffeine. In many other ways there has been excellent improvement in memory, attitude, and especially life enjoyment. So i would not give this regime up for any reason.

  5. Interesting study but lots of questions come to mind
    Is lower GABA level just the result of a negative feed back caused by the increased levels triggered by Ritalin and not functional significant. Would a period of being off medication allow the GABA levels to rise? Also it is a small sample so a repeat study with a larger sample would be helpful.
    If anything I would be reassured by this study

  6. Could I get a reference to to study? A link or the name of the study, anything really.

    I personally hate medication and quit Ritalin when I turned 18. I took it from age 12 to 18 and it made me sluggish and tired. After quitting I had a huge difficulty focusing and controlling myself. I smoked weed for about 4 years then quit. I found that weed helped to stabilize my mood and energy without the sluggish feeling. I quit smoking and I’m 28 now. I’m still a bit childish with a vary high energy level, but I don’t struggle with attention or self control as much. My anicdote is a bit interesting considering that marijuana and Ritalin have both been found to create developmental problems in the frontal lobe specifically. Maybe the reason I was able to achieve a higher functioning mind as a result is due to Ritalin and marijuana producing a similar result in the brain. I would like to see a similar about marijuana side by side with this. However, we’d need to change weed from schedule 1 to schedule 2 before that could happen.

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