Nootropics for ADHD: What You Should Know

ADHD affects approximately 11% of children and 5% of adults in the United States. The treatment often consists of a combination of behavioral therapy, psychotherapy, and medications. This article provides an overview of the various medications (nootropics) available for the treatment of ADHD.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is characterized by a mixture of impulsive behavior, problems focusing, and overactivity. The Center for Disease Control and Prevention (CDC) estimates it to be one of the most common neurodevelopmental disorders in children.

ADHD can also affect adults. Approximately 50% of children with ADHD will continue to have symptoms in adulthood. These symptoms can have detrimental effects on one’s work and personal success.

Symptoms of ADHD

The symptoms of ADHD are broken down into two different types, inattentive and hyperactivity/impulsivity.

Inattentive ADHD is characterized by difficulty concentrating on tasks, poor listening skills, and being easily distracted. It also leads to problems completing tasks, reluctance to take on tasks requiring prolonged focus, and forgetfulness during daily activities.

Hyperactivity/impulsivity ADHD is associated with a sense of restlessness/fidgeting and an inability to sit still or play quietly. Problems with taking turns, interrupting others, and blurting out answers are also seen in this type of ADHD.

Based on these symptoms, there are three different presentations of ADHD:

• Combined presentation: display symptoms of both inattentiveness and hyperactivity/impulsivity.
• Predominantly inattentive presentation: mainly have symptoms of inattentiveness.
• Predominantly hyperactive-impulsive presentation: mainly have symptoms of hyperactivity/impulsivity.

How do nootropics work for ADHD?

Nootropics for ADHD are medications or supplements that help to improve attention and executive function (thought to reduce impulsivity). This is accomplished by increasing the levels of two chemicals, dopamine and norepinephrine, in the brain.

When discussing nootropics for ADHD they are often divided into three groups:

1. Stimulants.
2. Non-stimulants.
3. Complementary/alternative medications (CAM).

Stimulants have been traditionally used in ADHD for many years and consist of methylphenidate (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse). They are viewed as the most effective medications in the treatment of ADHD.

A meta-analysis evaluating 23 studies, found amphetamines to be moderately more effective than methylphenidate.

However, stimulants are estimated to either not work or are not tolerated by 10–30% of patients. Therefore, other treatments are often sought to help manage the symptoms of ADHD.

Non-stimulants are becoming increasingly used in ADHD. These consist of tricyclic antidepressants (TCA), alpha–2–adrenergic agonists, and atomoxetine (Strattera).

• TCAs — studies have proven them to be effective, but side effects limit their use.
• Alpha-2-adrenergic agonists — have shown promise in ADHD, but the evidence is limited.
• Atomoxetine — numerous studies have shown atomoxetine to be effective in the treatment of ADHD with few side effects.

CAMs are often considered to treat or supplement other nootropics in managing of ADHD. However, there is limited scientific evidence supporting their use despite a plethora of claims on the internet.

Supplements — zinc, iron, and magnesium provide benefits only if you have a deficiency. Melatonin can help improve sleep in ADHD patients. Omega-3 fatty acids have been shown to have a modest effect on ADHD symptoms. A simple blood test may be needed to see if supplements such as zinc, iron, and magnesium can provide benefits in the treatment of ADHD.

Herbal medications — Korean red ginseng, ningdong granule, and bacopa monnieri have shown promise in the management of ADHD. In addition, these herbal supplements have been shown to have few side effects and to be well tolerated. However, many studies evaluating their use are limited by a small number of participants.

Please remember, it is important to discuss starting any alternative medication with your doctor, especially in children.

What prescriptions drugs are used for ADHD treatment?

Numerous anecdotal reports claiming success with various 'smart drugs' are common on the internet. The scientific evidence backing these claims continues to be scarce. However, here are the most used 'brain drugs' including some herbal supplements:

• Methylphenidate.
• Amphetamines.
• Atomoxetine.
• Korean red ginseng.
• Ningdong granules.
• Bacopa monnieri.

There is no shortage of nootropics (especially herbal supplements) claiming success in treating ADHD. Before starting any of these medications, talk with your doctor to make sure what you are taking is safe and effective. Remember, it may take some time to find a regimen that successfully treats ADHD without causing side effects.