Ask the Experts

Why Doesn’t Everyone with ADHD Need Meds?

“If ADHD is caused by a chemical imbalance of neurotransmitters in the brain, doesn’t it follow that all children with attention deficit need medication to correct the imbalance?”

This is an interesting and important question. It does appear that children with ADHD have differences in certain aspects of brain function. The most important difference seems to be in the frontal lobe, which results in problems with executive function. This may be influenced by differences in the production or metabolism of two neurotransmitters, dopamine and norepinephrine. This is the chemical imbalance you refer to.

There are three important things to remember. First, the nature of this neurotransmitter difference, or imbalance, is far from clear. It is not as simple as a lack of dopamine or norepinephrine. Second, neurotransmitter function and balance are not fixed, but are constantly changing. Finally, and most important, there are many factors that influence neurotransmitter function. Psychological stress, social interaction, electronics, and even nutrition may change the neurotransmitter function. Taking medication is one of the many ways in which neurotransmitter balance can be altered, and it is not always the best way.

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