Central nervous system stimulant medicines are the most commonly prescribed medications to treat symptoms of attention deficit/hyperactivity disorder (ADHD). These stimulants activate the level of activity, arousal, or alertness of the central nervous system. They work by “stimulating” and increasing the availability of certain neurotransmitters in the brain, making pathways in the brain work more effectively.
There are two main medicines within the stimulant class of drugs. These include methylphenidate which is the generic name for such brand name medications as Ritalin, Concerta, Methylin, Metadate, Focalin, Daytrana and amphetamines, the generic for such brand names as Dexedrine, Adderall, and Vyvanse.
All three subtypes of ADHD -- the Combined type, the Predominantly Hyperactive-Impulsive type, and the Predominantly Inattentive type -- respond to stimulant therapy.
Caffeine is also a central nervous system stimulant. Is caffeine an alternative therapeutic strategy for the management of ADHD symptoms? Can a few cups of coffee a day effectively improve mental focus and attention and reduce impulsive or hyperactive behavior in children with ADHD?
Research on Caffeine and ADHD
Research published in the International Journal of Neuropychophamacology (December 2005) studied the effect of caffeine on animal models of ADHD – rats with ADHD-like symptoms including hyperactivity, impulsivity, poorly sustained attention, and deficits in learning and memory processes. The study found that caffeine improved several learning and memory impairments in the animal models of ADHD.
Research published in the journal Neuroscience Letters (2011) further evaluated the effect of caffeine on motor activity and attention deficit, again using a genetic animal model of ADHD. In the study investigators observed no changes in the motor activity measurements before and after caffeine administration, however a significant improvement in the attention deficit of the ADHD rats was achieved after caffeine treatment.
Caffeine for ADHD in Children?
Though improvements have been noted in animal models and in anecdotal reports, research on the safety and effectiveness of caffeine in the treatment of ADHD is very limited. We tend to think of caffeine as an innocuous substance – after all it is naturally found in coffee, tea, and cocoa – , however, it is still a drug and a central nervous stimulant.
Many pediatricians caution against the use of caffeine as a treatment choice for ADHD. Caffeine is less effective than methylphenidate or amphetamines for ADHD. It also tends to be shorter acting as compared to the stimulant medications, so any positive effects are shorter lasting. In addition, there are currently no dosage recommendations for managing ADHD with caffeine.
Like all stimulants, caffeine can result in negative side effects such as anxiety, restlessness, insomnia, stomachaches, and tachycardia when consumed in higher doses. Children are often more susceptible to these adverse effects as compared to adults.
At this time there is insufficient information available to recommend caffeine for children with ADHD. Treatment approaches with documented efficacy and safety include behavioral interventions and when indicated prescription stimulant medication.
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Prediger RD, Pamplona FA, Fernandes D, Takahashi RN.; Caffeine improves spatial learning deficits in an animal model of attention deficit hyperactivity disorder (ADHD) -- the spontaneously hypertensive rat (SHR) Int J Neuropsychopharmacol. 2005 Dec;8(4):583-94. Epub 2005 May 9.
Caballero, Miguel;Núñez, Fabiana;Ahern, Siobhán;Cuffí, Maria L;Carbonell, Lourdes;Sánchez, Silvia;Fernández-Dueñas, Víctor;Ciruela, Francisco; Caffeine improves attention deficit in Neonatal 6 OHDA Lesioned rats, an animal model of attention deficit hyperactivity disorder (ADHD), Neuroscience Letters, Volume 494, Issue 1, 20 April 2011, Pages 44-48.