ADHD, Genetics, and Stimulant Medication Adherence

For many people with ADHD, stimulant medications, which are known to be very effective, can cause so many side effects that they stop using them and try non-stimulant treatments instead.

A recent study published in The American Journal of Psychiatry attempts to understand some of the factors related to a person’s decision to discontinue stimulant use. The researchers found that the type of diagnosis, and the age at which the diagnosis is made, can make a difference.  For instance, people with ADHD who had a higher genetic risk of also having a mood and/or psychotic disorder, those who have a delayed ADHD diagnosis, and those with other psychiatric diagnoses are more likely to discontinue stimulant use. While many questions remain, the findings suggest that people who discontinue stimulant medication may share some genetic similarities. This insight may be helpful in guiding future research and treatments.

Reports & Perspectives

  • Science Daily calls attention to the fact that people with ADHD are at risk for a number of co-occurring conditions which, in many cases, are due to genetic factors. The authors emphasize that it’s important to identify these other diagnoses in order to prescribe the most effective treatment.
  • A study looking at the effects of stimulant medications on guppies that was published in Scientific Reports finds that the medications have the potential to cause changes that can be passed down to future generations.
  • @ActaPsychScand (journal) tweets: “New publication in @ActaPsychScand by @StephenFaraone and colleagues: ‘Rates of Switching Stimulants in Consecutively Referred Medication Naïve Adults with ADHD”
  • @IMD_UoB (a mental health institute) shares: “Our colleagues @PsychMarwaha are leading the research to evaluate the clinical and cost-effectiveness of stimulant compared with non-stimulant medication for adults with ADHD and a history of…”

In Practice

ADHD and Alzheimer’s Disease Linked Across Generations

What’s Happening

While ADHD is typically first diagnosed in childhood, researchers from Sweden recently explored the relationship between ADHD and older individuals with Alzheimer’s disease to see if the two conditions that span different generations might be linked. Prior studies seeking a relationship between the two disorders have been inconclusive. However, by scanning data from national registers of more than 2 million people born between 1980 and 2001 and tracking close relatives, the Swedish scientists discovered that there is in fact a connection between both diagnoses, as well as with other forms of dementia.

Published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, their findings confirmed that:

  • Relatives of people with ADHD had a higher likelihood of having Alzheimer’s.
  • Early-onset Alzheimer’s was more likely to be related to ADHD than later onset.
  • The closer the relationship, the stronger the link – meaning that parents of children with ADHD had a higher risk of having Alzheimer’s than that child’s grandparents, aunts, and uncles.

These findings call attention to the need to better understand genetic changes and lifestyle factors that could underly both ADHD and Alzheimer’s disease in order to address these conditions and act preventively. It’s worth noting, however, that ADHD has only begun being adequately diagnosed in recent years, so it is not possible to fully track the ADHD history of older patients who have Alzheimer’s.

Reports & Perspectives

  • An expert quoted in Attitude Magazine says ADHD can’t cause AD or dementia. The expert also points out that many women who experience trouble concentrating and worry they could have early-onset Alzheimer’s may actually have ADHD that emerged after menopause.
  • Harvard Health Publishing reveals that older adults who have difficulty with concentration, organization, and planning – and who worry these are signs of dementia – may be surprised to find out they could really be experiencing ADHD.
  • Science Daily reports that adults with ADHD are at risk for a variety of physical health problems.
  • @progressnp (resource for clinicians) tweets: “ADHD has been identified as a risk factor for Alzheimer’s disease, and relatives of people with ADHD are more likely to develop AD, suggesting common genetic and/or environmental mechanisms for the two disorders:”
  • @virtilabs (immersive training platform) says: “A new #study has revealed that #virtualreality boosts brain activity that may be crucial for #learning, #memory and even treating Alzheimer’s, ADHD and depression.”

In Practice

When People with Autism Present with Eating Disorders

What’s Happening

New research indicates that anorexia nervosa, a serious eating disorder, and autism spectrum disorder (ASD), a neurodevelopment disorder, may co-occur. But little is understood about the onset and timing of each: are young people with ASD more likely to develop anorexia in their teen years, or does the development of anorexia cause behaviors such as social withdrawal, compulsions, and repetitive behavior that are typically associated with autism? Several research teams have attempted to answer these questions. One recent effort, which appeared in Molecular Autism, compared symptoms in females with anorexia and those with ASD. They discovered that ASD symptoms were similar in both patients with ASD and anorexia, especially when it comes to repetitive behaviors. One area of difference, however, was noted in social interactions, as those with ASD seemed to struggle more to understand social cues than their counterparts with anorexia.

Another study, this one published in The Journal of Child Psychology and Psychology, explored whether ASD traits existed in people before being diagnosed with anorexia. Interestingly, the researchers did not find ASD traits in 9-year-old children who later went on to be diagnosed with anorexia in their teen years.

Why it’s Complicated

When people with ASD experience eating disorders, it may be related to factors such as sensory issues, anxiety, or difficulty reading hunger cues rather than the more typical challenges around body image and self-esteem. Thus, people with ASD may also need different treatment approaches that are more tailored for their needs (see our Psy-Q on multifaced approaches to treating eating disorders on those with autism).

Reports & Perspectives

  • An article in Autism Parenting Magazine looks at the different types of eating disorders that may affect young people with autism.
  • According to a study in the International Journal of Psychiatry Research, those with autism and eating disorders may benefit from participating in art and music therapy as part of an individualized treatment plan.
  • The Journal of Eating Disorders reports on the strain parents/caregivers face when taking care of a person with an eating disorder and ASD, and calls attention to the need to provide more support.
  • A piece in BCC News calls attention to the growing number of young people in Ireland requiring help for an eating disorder during the COVID-19 pandemic, and mentions that some children with autism who could not access needed supports for ASD or ADHD ended up developing eating disorders.
  • @NHFTNHSLibrary tweets: “One size doesn’t fit all: new insights into #eatingdisorders and #autism nationalservice.net/mental-health/…@Mental_Elf on the #research #evidence from a recent study. #anorexia”
  • @AMRC (a UK-based mental health charity) shares: “The co-existence of autism and an eating disorder can make healthcare teams feel this is just too complicated, we don’t really want to know” and points to a related webinar.
  • @acamh (Association for Child and Adolescent Mental Health) tweets: “Are autistic behaviours a trait or a state of anorexia nervosa? Anorexia nervosa (AN) and autism spectrum disorder (ASD) seem to co-occur more frequently than would be expected by chance….” and points to their article.

In Practice

  • Read our report on “The Interplay Between Medical Conditions and Mental Health.”
Last Updated: Sep 30, 2021