Huberman Lab Podcast: Treatment of ADHD

Host: Andrew Huberman

• Professor of Neurobiology and Ophthalmology at Stanford School of Medicine

Topic: Stimulants for ADHD Treatment

• Focus on drugs like Adderall, Ritalin, Vyvanse, and non-stimulant prescription drugs like modafinil and guanfacine.
• Discussion includes how these compounds work, addictive potential, psychotic symptoms, and long-term consequences.

ADHD Medication

Common Stimulants

• Adderall, Ritalin, Vyvanse: Commonly used for ADHD.
• Also used non-prescription by college-age individuals, often obtained through black markets.

Risks

• Black market drugs often contain fentanyl, a deadly contaminant.

Mechanism of Action

• Stimulants enhance focus by modifying brain networks, especially the prefrontal cortex.
• They increase dopamine and norepinephrine to improve attention and reduce hyperactivity.

Common Questions

• How do stimulants reduce hyperactivity?
• What are the effects on sleep, hormone health, reproductive health, and height?
• Do these medications predispose individuals to other substance addictions?

The Prefrontal Cortex and Attention

• Critically important for orchestrating neural circuits that control focus and attention.
• ADHD involves hyperconnected brain networks rather than deficiencies.

Neuromodulators

• Dopamine: Reduces noise, improves focus.
• Norepinephrine: Increases signal, helps focus on specific tasks.

Types of ADHD Medications

Adderall

• Combination of D-amphetamine and L-amphetamine.
• Mainly increases dopamine and norepinephrine.

Vyvanse

• Timed-release D-amphetamine with lysine.
• Developed to reduce abuse potential.

Ritalin (Methylphenidate)

• Increases dopamine more than norepinephrine.
• Short-acting compared to Adderall and Vyvanse.

Non-Stimulant ADHD Treatments

Modafinil

• Used off-label for ADHD, primarily for increasing wakefulness.

Guanfacine

• Non-stimulant, lowers blood pressure, used in combination therapy.

Long-term Effects and Considerations

Children and ADHD Medication

• Early treatment can normalize executive function.
• Little evidence of height restriction with proper dosage.

Risks and Benefits

• Untreated ADHD can increase risk of substance abuse.
• Properly treated ADHD leads to better long-term outcomes.

Dosage and Treatment

• Dosage varies widely; must be tailored for each individual.
• Importance of combining medication with behavioral treatments.

Cautions

• Avoid alcohol and benzodiazepines when on ADHD medications.
• Psychotic episodes are a risk for individuals predisposed to them, especially with amphetamines.

Conclusion

• ADHD drugs are more effective than treatments for other psychiatric conditions.
• Proper management involves medication, behavioral treatments, and regular consultations with qualified professionals.

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Additional Resources

• For more information and discussions on ADHD and treatments, visit hubermanlab.com