Without ADHD, Adderall Does Not Improve Cognition

ADHD drugs don’t improve cognition of college students who don’t have the condition, a small pilot study suggests. Not only that, but taking them could actually impair functioning, say researchers, who expected different results.

“We hypothesized that Adderall would enhance cognition in the healthy students, but instead, the medication did not improve reading comprehension or fluency, and it impaired working memory. Not only are they not benefitting from it academically, but it could be negatively affecting their performance.”

said Lisa Weyandt, a professor of psychology and faculty member at the George and Anne Ryan Institute for Neuroscience at the University of Rhode Island.

Studying Study Drugs

The first of it’s kind multisite pilot study of the impact of so-called “study drugs” on college students who do not have ADHD comes at a time when use of prescription stimulants such as Adderall, Ritalin, and Vyvanse is common among young adults who believe the drugs will improve their academic performance, researchers say.

Studies by Weyandt and others have estimated that 5 to 35 percent of college students in the United States and European countries without ADHD illegally use these controlled substances, buying or receiving them from peers, friends, or family.

The findings show that the standard 30 mg dose of Adderall did improve attention and focus — a typical result from a stimulant — but that effect failed to translate to better performance on a battery of neurocognitive tasks that measured short-term memory, reading comprehension, and fluency.

Participants in the study also reported their perceived effects of the drug and its impact on their emotions, with students reporting significant elevation of their mood when taking Adderall.

Cognitive Vs. Emotional Impacts

In contrast to the small, mixed effects on cognition, the drug had much larger effects on mood and bodily responses, increasing positive mood, emotional ratings of the drug effect, heart rate, and blood pressure.

“These are classic effects of psychostimulants. The fact that we see these effects on positive emotion and cardiovascular activity, in the same individuals for whom cognitive effects were small or negative in direction, is important. It indicates that the cognitive and the emotional impact of these drugs are separate. How you feel under the drug does not necessarily mean that there is an improvement in cognition; there can be a decrease, as seen here in young adults without ADHD,”

said Tara White, an assistant professor of research in behavioral and social sciences at Brown University’s Center for Alcohol and Addiction Studies. The physical effects from the drugs, such as increased heart rate and blood pressure, were expected, and underscored the difference with cognition.

“They are subjecting themselves to physiological effects but do not appear to be enhancing their neurocognition,”

Weyandt said. She stressed, however, that the findings are based on a pilot study and need to be replicated with a substantially larger sample of college students.

Weyandt has a theory about why working memory would be adversely affected by the medication. Brain scan research shows that a person with ADHD often has less neural activity in the regions of the brain that control executive function — working memory, attention, self-control.

For people with ADHD, Adderall and similar medications increase activity in those regions and appear to normalize functioning.

“If your brain is functioning normally in those regions, the medication is unlikely to have a positive effect on cognition and my actually impair cognition. In other words, you need to have a deficit to benefit from the medicine,”

Weyandt said.

The research was supported by grants from the Rhode Island Neuroscience Collaborative, Brown’s Carney Institute for Brain Science, the George and Anne Ryan Institute for Neuroscience, and the Norman Prince Neurosciences Institute at Rhode Island Hospital as well as divisions within the National Institutes of Health and the National Science Foundation.

Weyandt, L.L.; White, T.L.; Gudmundsdottir, B.G.; Nitenson, A.Z.; Rathkey, E.S.; De Leon, K.A.; Bjorn, S.A.
Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students
Pharmacy 2018, 6, 58.

Image: UBC Learning Commons/Flickr