What Does This Mean
People with an ADHD diagnosis were shown to have more than 2-fold increased risk of a subsequent diagnosis of BG& C diseases including and specifically PD compared to people with no history of ADHD. That 2-fold increased risk includes BG& C diseases such as secondary parkinsonism, other degenerative diseases of the basal ganglia, and essential tremor.
Of particular note, for people on ADHD medication, their risk of PD doubled to 4-fold, compared to people without ADHD. Further, according to the most recent data available from the Centers for Disease Control and Prevention , approximately 9.4% of children 2-17 years of age had ever been diagnosed with ADHD, and almost two thirds were taking medication . While results from this study suggest people taking certain ADHD medications may be at an increased risk for earlier-onset BG& C diseases , this is just a single study, and results have not been replicated. In addition, even with an increase in risk, the overall risk in developing PD is still very small. Always talk to your doctor regarding any health concerns you may have.
A Critical Reappraisal Of The Worst Drugs In Parkinsons Disease
What are the worst drugs for Parkinsons disease patients? Couldnt a simple list be assembled and disseminated to the Parkinson community? Recently Ed Steinmetz, an experienced neurologist in Ft. Meyers, FL pointed out to me, a list approach published in the Public Citizen Newsletter . The approach was to list every drug associated with a single confirmed or unconfirmed symptom of Parkinsons disease or parkinsonism. Parkinsons disease is defined as a neurodegenerative syndrome , whereas parkinsonism encompasses a wider net of drug induced and other potential causes. In parkinsonism symptoms are similar to Parkinsons disease, but patients do not have Parkinsons disease. Patients and family members confronted with a simple drug list approach may falsely conclude that most medicines are bad for Parkinsons disease, and that any medicine may cause parkinsonism. This concept is in general, incorrect. Although the approach is well-meaning, it is in need of a major revision, as Parkinsons disease and parkinsonism are too complex to summarize by simple lists. In this months column I will try to summarize the key information that patients and family members need to know about the worst pills, for Parkinsons disease and parkinsonism.
A Florida Parkinsons Treatment Blog by Michael S. Okun, M.D.
UF Center for Movement Disorders & Neurorestoration, Gainesville FL
Is There A Link Between Adhd And Dementia
A 2022 study suggests that ADHD may increase the risk of dementia and mild cognitive impairment. The risk may be higher in males than in females.
ADHD may also link to risk factors for dementia, such as low educational attainment, metabolic syndrome, sleep disorders, head injuries, and psychiatric disorders.
After taking into account any psychiatric disorders, the risk of dementia in relation to ADHD was lower. Other risk factors, such as those above, had a limited effect on dementia risk.
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How To Talk To Your Doctor
If you want to talk to your doctor about medications or any other concerns you have, we put together a great video with great strategies for making the most out of your time together. You can watch the video here, and be sure to check out all of the videos we have on our YouTube channel and subscribe so youre the first to know when we share something new.
Methylphenidate For The Treatment Of Parkinson Disease And Other Neurological Disorders
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- Psychology, Medicine, Biology
- Clinical Neuropharmacology
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- Soa–ch’ongsonyon chongsin uihak = Journal of child & adolescent psychiatry
- European Journal of Clinical Pharmacology
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Before Taking This Medicine
You should not use Ritalin if you are allergic to methylphenidate, or if you have.
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a personal or family history of tics or Tourette’s syndrome or
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severe anxiety, tension, or agitation .
Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:
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heart problems or a congenital heart defect
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high blood pressure or
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a family history of heart disease or sudden death.
Do not use Ritalin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.
Tell your doctor if you also use opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with methylphenidate could cause a serious condition called serotonin syndrome.
Tell your doctor if you or anyone in your family has ever had:
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depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions
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blood circulation problems in the hands or feet or
To make sure Ritalin is safe for you, tell your doctor if you have:
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problems with the esophagus, stomach, or intestines or
Ritalin is not approved for use by anyone younger than 6 years old.
Adhd Drugs Associated With A Dramatic Increased Risk For Parkinsons
Estimates indicate that approximately 11% of school-aged children in United States have attention-deficit/ hyperactivity disorder . Further, approximately 2/3 of these children are currently being medicated for this diagnosis. The most common medications are essentially stimulants like amphetamines or methylphenidates, including drugs like Adderall and Ritalin.
The areas of the brain that are potentially damaged or disrupted by these medications include the basal ganglia, brain structures that are involved in coordinated movement. The other area that is potentially involved is the cerebellum, which also plays a role in movement.
In a recent study published in Neuropsychopharmacology, researchers from the University of Utah attempted to determine if children with ADHD had an increased risk of Parkinsons disease or other issues related to damage to the areas of the brain described above. Further, they wanted to determine if in fact being treated for ADHD might increase risk for Parkinsons down the line.
The research involved the review of more than 11 million individuals and ultimately arrived at a cohort of around 32,000 individuals who had a history of being diagnosed with ADHD. These subjects were at least 20 years of age in 2011 and of them, approximate 5,000 had been treated with stimulant medications, again for ADHD. These subjects were compared to approximately 160,000 individuals in whom there was no history of ADHD.
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Methylphenidate And Parkinson’s Disease
Parkinson’s disease is a common disorder caused by the loss of dopamine-producing brain cells. The disorder is generally treated with levodopa combined with carbidopa. Nerve cells use levodopa to make dopamine. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Motor fluctuations are a common, and often difficult to manage, source of disability in people with PD. In this trial researchers will study the effects of methylphenidate , also known as Ritalin-a drug marketed in the U.S. to treat hyperactivity and narcolepsy-on carbidopa/levodopa and other antiparkinson medications taken orally by individuals with Parkinson’s disease who experience motor fluctuations when they take levodopa. The overall goal of this project is to develop better symptomatic therapies for PD. After 2 screening visits to the treatment clinic to evaluate the wearing “on” and “off” effects of levodopa, eligible participants will be scheduled for 3 admissions to the GeneralClinical Research Center at Oregon Health & Science University during which they randomly will receive the study drug, MPD, or placebo, along with their usual carbidopa/levodopa therapy and/or other antiparkinson medications. Also, participants will have their parkinsonism rated and blood pressure and pulse measured at regular intervals. Duration of the study for participants is about 3 weeks and includes 2 outpatient clinic visits and 3 inpatient clinic visits .
Parkinsons Disease And Adhd
Researchers are now suggesting a possible link between Parkinsons and ADHD. According to the Parkinsons Foundation, this link may be due to the areas of the brain that the conditions affect.
These two areas of the brain the basal ganglia and the cerebellum both require healthy amounts of dopamine to function properly.
The basal ganglia refer to a collection of nerve cells that work as messengers between the brain and the nervous system, providing information to the spinal cord and cerebellum. The basal ganglia help control motor functions, behaviors, and emotions.
The cerebellum sends messages to the muscles to help control posture and movements such as walking, as well as coordination, reflexes, and head and eye movement.
Research has shown that people with ADHD have damage to the nerve cells that produce dopamine in the basal ganglia, as well as abnormal cerebellar differences.
Damage to nerve cells in the basal ganglia and changes in dopamine production, as well as cerebellar involvement, also occur with Parkinsons.
2021 article suggests that ADHD may increase the risk of diseases that affect the basal ganglia and cerebellum, known as BG& C diseases. These include Parkinsons disease.
Factors that contribute to this association may include the neurotoxic effects of stimulant medications, environmental factors, and Lewy bodies, which are deposits of protein in the brain.
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Can Stimulants Prevent Parkinsons
According to a 2022 article , certain stimulants may help reduce symptoms of Parkinsons disease, such as cognitive and motor problems.
Research suggests that methylphenidates are relatively safe in comparison with amphetamines and may improve motor and non-motor symptoms in people with Parkinsons.
However, stimulant use cannot prevent Parkinsons from developing. Chronic use of amphetamines may increase the risk of developing Parkinsons.
Alternative Adhd Medications To Consider
Adderall is the most common prescription used to treat ADHD, but it is not the only one. There are two primary types of medications used for ADHDstimulant and non-stimulant. These have the same purpose of helping you focus and feel calm. Tell your doctor about all your current medications and existing conditions so they can determine which one will likely work best for you.
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New Research Finds Link Between Adhd And Parkinson Disease
Researchers from the University of Utah explain that patients with attention-deficit/hyperactivity disorder were more than twice as likely to develop early-onset Parkinson disease or a related basal ganglia and cerebellum disease than peers who do not have ADHD. Among patients with more severe disease who are prescribed stimulant medications to control their ADHD, the risk was 6- to 8-fold higher.
Attention-deficit/hyperactivity disorder affects approximately 11% of children in the United States, and some previous research has suggested that that exposure to stimulants commonly used to treat the disorder can result in persistent basal ganglia dopaminergic deficits. Now, new research shows that patients with ADHD have an increased risk of developing Parkinson disease and related basal ganglia and cerebellum diseases, and patients treated with stimulants have an even greater risk.
In a paper today in Neuropsychopharmacology, researchers from the University of Utah explain that patients with ADHD were more than twice as likely to develop early-onset PD or a BGC disease than peers who do not have ADHD. Among patients with more severe disease who are prescribed stimulant medications to control their ADHD, the risk was 6- to 8-fold higher.
In the ADHD cohort, the rate of incident BGC diseases was 0.52%, compared with 0.19% in the non-ADHD cohort, and the age of disease onset was slightly younger among patients with ADHD than in those without ADHD .
Stimulant Adhd Medications And Your Digestive System
Stimulant ADHD medications increase how much glucose gets released into your system, which can cause all sorts of digestive issues. You might lose your appetite, resulting in unexpected and unwanted weight loss. This can be especially harmful to children who are still growing. Adults usually only experience weight loss temporarily, and they regain their appetite soon after their body adjusts to the medication.
Some digestive issues people who take stimulant ADHD medications might experience include the following:
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Methylphenidate Use For Fatigue In Parkinsons
Methylphenidate , better known by its brand name, Ritalin, is popular for its use in the treatment of children with ADHD. It was FDA approved in the 1950s and became increasingly prescribed in the 1990s. MP has since been used for other disorders, including narcolepsy, refractory depression and fatigue caused by medical and neurological disorders.
Fatigue in Parkinsons is a common problem encountered by one-third to one-half of people with the disease. Parkinsons fatigue is often unrelated to the disease severity and overall motoric disability. Medications used to treat the motor symptoms of Parkinsons typically do not improve fatigue, and treatment specific to fatigue is lacking.
MP is a psychostimulant which has seen an increase in off-label use to treat Parkinsons fatigue. MP works by decreasing the reuptake of neurotransmitters, like dopamine and norepinephrine, thus making them available longer in the synaptic cleft where the chemicals can act on the receiving brain cells.
Based on their clinical experience, many physicians are recommending that patients try MP for Parkinsons fatigue, especially when quality of life is greatly impacted.
MP is an old drug that may have newer uses it may have potential to help people with Parkinsons. As with all medications, discuss the risks and benefits of MP with your neurologist and other healthcare team members before deciding if it is right for you.
What The Results Mean
The results from the above study show an increased risk of BG& C diseases in those with ADHD. This means that people with ADHD may be more likely to develop diseases such as Parkinsons than those without ADHD.
The results also demonstrate that taking prescription stimulants for ADHD may further increase a persons risk of developing diseases such as Parkinsons.
However, the authors note that this result could be because people who use medications have a more severe form of ADHD. Therefore, the increased risk could be due to the severity of the condition rather than a direct result of medication use.
According to the study, having ADHD may also increase the risk of earlier onset BG& C diseases, particularly in those who take prescription stimulants.
The authors also acknowledge that other factors that they did not take into account, such as brain injuries, head trauma, and environmental toxins, may play a role in the development of ADHD and Parkinsons.
About 1015% of Parkinsons cases are due to genetics. Environmental factors can also play a part in the development of Parkinsons. Avoiding risk factors for Parkinsons, where possible, may help lower the risk.
Risk factors for Parkinsons include:
- exposure to certain metals and pesticides
- exposure to trichloroethylene and polychlorinated biphenyls
This section answers some common questions about Parkinsons disease and ADHD.
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Do Adhd Medications Cause Parkinsons
According to the Parkinsons Foundation, certain ADHD medications may increase the risk of developing BG& C diseases, including Parkinsons.
So far, there is not enough research to reach a definite conclusion, and the increased risk of developing Parkinsons is small.
It is important that people with concerns about ADHD medications and Parkinsons discuss them with a doctor.
Link Between Adhd And Parkinson’s
Study results published in Nature Neuropsychopharmacology discussed the correlation between ADHD and developing PD. For those diagnosed but not treated, there was a 2.5x increase in the likelihood for developing PD, or a Parkinsons related disorder. For those that were treated with stimulants like Ritalin or other kinds of amphetamines, the increase spiked to a high of 8.6x.
Using the Utah Population Databases , the analysis looked at 200,000 Utah residents with Parkinsons born between 1950-1992. Within that population, around 32,000 had been diagnosed with ADHD. The review considered those at least 20 years old by 2011, who had no prior PD or PD-like diagnosis and excluded other known factors that might influence the development of PD.
The analysis looked at those who had been diagnosed with ADHD and received no known drug therapy. It also considered those who received stimulants like Adderall and others who were treated with methylphenidate . Researchers also looked at a control group of more than 150,000 people without ADHD who were matched by gender and age to the study population.
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Stimulant Adhd Medications And Your Circulatory System
All stimulants can impact your circulatory system in a few ways. They can make your heartbeat faster, increase your blood pressure, and constrict your blood vessels. You should avoid drinking alcohol when you take stimulant ADHD medications, as this can increase your likelihood of developing heart problems.
In a small number of extreme cases, people who take stimulant ADHD medications may experience a stroke or heart attack. Seek medical help immediately if you start to feel chest pain. People with pre-existing heart conditions can experience sudden death after taking stimulant ADHD medications.
What Happens If I Overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of methylphenidate could be fatal.
Overdose symptoms may include nausea, dry mouth, vomiting, diarrhea, anxiety, agitation, restlessness, tremor, muscle twitches, rapid breathing, confusion, hallucinations, dilated pupils, muscle pain or weakness, fever, sweating, headache, pounding in your neck or ears, fast or pounding heartbeats, feeling light-headed, fainting, seizure , or coma.
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How Should I Take Ritalin
Take Ritalin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Methylphenidate may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication where others cannot get to it. Selling or giving away Ritalin is against the law.
Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes.
Ritalin immediate release tablets are usually taken 2 to 3 times a day. Take Ritalin IR tablets 30 to 45 minutes before a meal.
Ritalin LA extended-release capsule are taken once daily in the morning.
You may take Ritalin LA capsules with or without food, but take them the same way each time.
Swallow the Ritalin LA extended-release capsule whole. If you cannot swallow the capsule whole, open it and mix the medicine with soft food such as applesauce, pudding or yogurt. Swallow the mixture right away without chewing.
Tell your doctor if you have a planned surgery.
Your treatment may also include counseling or other treatments.
Your doctor will need to check your progress on a regular basis. From time-to-time, your doctor may stop Ritalin treatment for a while to check ADHD symptoms. Your heart and blood pressure may also need to be checked often.