For children and adults with ADHD, medications like methylphenidate (e.g. Ritalin) and atomoxetine (Strattera) are commonly prescribed to help manage symptoms. While these drugs can improve focus and behaviour, their longer-term impacts—both positive and negative—are still being explored.A recent meta-analysis from King’s College London suggests that there are potential cognitive benefits from long-term treatment with stimulant and non-stimulant ADHD medications. Across 20 studies of methylphenidate and 8 studies of atomoxetine taken for at least 1-3 weeks, both drug types led to improvements in key areas like attention, inhibition, reaction time, and working memory compared to placebo (placebo is something that does not have any effect, like a medicine capsule filled with corn flour).
The cognitive effect sizes were small-to-medium for methylphenidate, but medium-to-large for atomoxetine (except for working memory). Lead author Professor Katya Rubia noted these cognitive enhancements “have implications for school and work performance” by addressing deficits that frequently impact academics and occupations.
However, the potential upsides need to be carefully weighed against the medications’ possible downsides and side effects, which the meta-analysis did not investigate. Stimulants like methylphenidate may cause sleep problems, appetite suppression, stomach-aches, and slightly delayed growth. Atomoxetine has also been linked to nausea, fatigue, and potential increases in heart rate and blood pressure and urine retention.
While Rubia says the findings underscore considering cognitive function “alongside behaviour” when treating ADHD, a holistic approach is warranted. Medications may help manage symptoms, but they are not an effortless solution nor are they risk-free. Other evidence-based treatments like behavioural therapy should be explored.
For those considering ADHD medications, have an open discussion with your doctor about your specific needs and weigh the pros and cons carefully. It is important to pay close attention to impacts on thinking skills, but also closely monitor side effects over time. With full information, each person can make a well-informed choice about the role medication should play in their ADHD treatment plan.