January 4, 2022

Taiwan population study finds association between ADHD and adrenal gland dysfunction

Cortisol is a steroid hormone produced by the adrenal glands situated above the kidneys. Its release is boosted by low blood sugar, which it counteracts, and also in response to stress.

Previous studies on children with ADHD have pointed to lower basal cortisol concentrations in the morning and a significantly lower incidence of typical diurnal fluctuation in cortisol levels.

To better assess the comorbidity of ADHD and adrenal gland disorders, a Taiwan research team affiliated with Chang Gung University College of Medicine used the National Health Insurance database to conduct a nationwide population study. Taiwan has a single-payer national health insurance system that encompasses almost the entire population, and its extensive database facilitates such studies.

Looking at the thirteen years from 1999 through 2011, the team identified 75,247 youths (manage ten years) newly diagnosed with ADHD and matched them by age and sex to another 75, 247 youths not diagnosed with ADHD.

To guard against confounding variables, they also identified psychiatric conditions that are comorbid with ADHD, including oppositional defiant disorder, conduct disorder, autism spectrum disorder, tic disorder, and intellectual disability.

After adjusting for age, sex, and psychiatric comorbidities, youths with ADHD were still 2.4 times more likely to have adrenal gland abnormalities than their normally developing peers. To place this in context, adrenal gland dysfunctions are very uncommon, in this instance occurring in roughly one in a thousand controls, and two in a thousand youths with ADHD.

The team also explored whether the two ADHD medications approved for use in Taiwan had any effect on the outcome. Methylphenidate, a stimulant, is the preferred treatment, with atomoxetine, a non-stimulant, used as an alternative where methylphenidate is inadvisable or found to be suboptimal. Neither methylphenidate nor atomoxetine had any significant effect on the risk of adrenal gland dysfunction.

The authors concluded, "Patients with ADHD had greater comorbid rates with adrenal gland dysfunction than the control subjects. Nevertheless, receiving pharmacotherapy (MPH or ATX) did not significantly influence the risk of developing adrenal gland dysfunction among ADHD patients. Therefore, continuous efforts are needed to promote public awareness of potential adrenal gland dysfunction among ADHD patients."

Pin-Han Peng, Meng-Yun Tsai, Sheng-Yu Lee, Po-Cheng Liao, Yu-ChiauShyu, and Liang-Jen Wang, "Attention-Deficit/HyperactivityDisorder, Its Pharmacotherapy, and Adrenal Gland Dysfunction: A NationwidePopulation-Based Study in Taiwan," International Journal of EnvironmentalResearch and Public Health(2020),17(10), 3709,https://doi.org/10.3390/ijerph17103709.

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How Early Parent–Child Interactions May Shape the Expression of ADHD Traits: A Longitudinal Study

We know that Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition with strong biological and genetic underpinnings; However, emerging research suggests that early environmental influences—particularly parent–child interactions—may shape how ADHD traits, such as impulsivity and delay aversion, are expressed during development.

This longitudinal study explored whether negative parental reactions during moments of delay contribute to the intensification of ADHD-related behaviors in preschool-aged children. A total of 112 mother–child pairs from the UK and Hong Kong participated. Children were screened for ADHD traits using the Strengths and Difficulties Questionnaire, ensuring a range of symptom severity. 

The experimental task—the Parent–Child Delay Frustration Task (PC-DeFT)—was designed to assess how children responded to brief, unpredictable waiting periods during a game-like activity, and how parents reacted in turn. During the task, children operated a button to change a red light to green, allowing their parent to retrieve a toy item. While most trials had no delay, six included unexpected 5–10 second pauses, creating mild frustration. Trained observers recorded children’s behavioral responses and parents' emotional reactions.

At follow-up (12–18 months later), teacher ratings revealed that children whose parents showed more negative reactions during delay trials (e.g., impatience, criticism) were more likely to exhibit increases in ADHD traits—especially impulsivity and difficulty waiting. Importantly, this link was mediated by increases in delay aversion, a motivational style where the child seeks to avoid frustrating waiting experiences. No such associations were found in free play or non-delay tasks, underscoring the specificity of this interaction.

The study’s findings suggest that, while these interactions do not cause ADHD, early social environments can influence how and when symptoms manifest. Interventions aimed at supporting positive parent–child interactions—particularly in challenging contexts like waiting—may help shape the developmental trajectory of children predisposed to ADHD.

May 15, 2025

Study Finds LSD Microdosing No More Effective Than Placebo For ADHD

Double-blind Randomized Clinical Trial Finds LSD Microdosing No More Effective Than Placebo in Treating ADHD Symptoms

Background:

Stimulants, such as methylphenidate and amphetamines, are currently considered effective medications for treating ADHD. However, approximately one-third of patients do not have an adequate response to these treatments. Additionally, long-term adherence is relatively low, with only about half of the patients still using methylphenidate after six years. 

Recently, there has been increasing attention to the concept of microdosing with psychedelic drugs such as psilocybin and LSD. A microdose typically ranges from one-tenth to one-twentieth of a recreational dose and does not produce noticeable perceptual effects or interfere with daily activities.  

The Study:

A European research team recently published the findings of the first double-blind, placebo-controlled randomized clinical trial examining the safety and efficacy of repeated low doses of LSD in adults diagnosed with ADHD. 

The six-week trial took place at University Hospital in Basel, Switzerland, and Maastricht University, Netherlands. Participants, aged 18 to 65, had clinical diagnoses of ADHD with moderate to severe symptoms.  

The team excluded persons with a past or present diagnosis of psychotic disorders, substance use disorders, or other psychiatric or somatic disorders likely to require hospitalization or treatments. 

Participants were randomly assigned in a 1:1 ratio to receive either LSD or placebo. Neither study staff nor participants were aware of the assignments until the conclusion of the trial. 

During the six-week trial, participants received twice-weekly doses on-site, amounting to a total of 12 doses. Following the first and final doses, participants were asked to determine whether they had been administered LSD or a placebo in order to assess blinding. Four weeks after the conclusion of the microdosing period, participants returned for an evaluation of the treatment's safety and efficacy. 

Twenty-seven of the 53 participants were randomized to receive the LSD microdosing treatment in a liquid solution, and 26 to receive placebo. Placebo consisted of the same drinking solution, minus the microdose of LSD. 

The average age was 37, and 42% of participants were female. Forty-six of the 53 participants completed the study. 

Out of 29 participants, 21 from the LSD group and eight from the placebo group correctly guessed their allocation, totaling 63% overall.  

As assessed through the Adult ADHD Investigator Symptom Rating Scale, ADHD symptoms improved by 7.1 points in the LSD group and 8.9 points in the placebo group, with no significant difference between them. 

Regarding safety, the LSD group experienced nearly double the adverse events compared to the placebo group. None of the events in either group were classified as serious. The five most frequent adverse events were headache, nausea, fatigue, insomnia, and visual alterations, occurring around three times more frequently in the LSD group than in the placebo group. 

The team concluded, “although repeated low-dose LSD administration was safe in an outpatient setting, it failed to demonstrate efficacy compared with placebo in improving ADHD symptoms among adults.” 

Conclusion: Microdosing with LSD did not offer significant advantages over placebo in treating ADHD symptoms, despite being physically safe and well tolerated in the trial setting. This suggests that further research is needed to explore alternative treatments for ADHD.

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April 23, 2025

Acupuncture for ADHD: A Promising Alternative or Placebo? A Look at Recent Research

Attention Deficit Hyperactivity Disorder (ADHD) is a common condition affecting children and adolescents worldwide, characterized by symptoms such as hyperactivity, impulsivity, and inattention. While traditional treatments like medication and behavioral therapy are often used, some individuals are turning to complementary and alternative therapies (CAM) for help. One such option gaining attention is acupuncture. But does it really work for ADHD?

A recent comprehensive study aimed to evaluate the effectiveness of acupuncture in treating ADHD symptoms. Here’s a breakdown of the findings, with a focus on the age groups included in the research and what these findings could mean for ADHD treatment options.

What the Study Explored

The study in question conducted a systematic review and meta-analysis (SR/MA) of acupuncture trials for ADHD, comparing its effects to traditional treatments such as pharmacotherapy and behavioral therapy. The researchers focused on acupuncture’s impact on core ADHD symptoms like hyperactivity, impulsivity, inattention, and conduct problems, while also exploring how acupuncture might help with other issues, such as learning difficulties and psychosomatic symptoms.

One key feature of this study was the inclusion of a broad age range of participants, specifically children and adolescents. These two groups are the most commonly diagnosed with ADHD, and their responses to treatments can vary significantly. Understanding how acupuncture works for these age groups is critical for evaluating its effectiveness as an ADHD treatment.

Here’s what the study found across the different age groups:

  • Children: Acupuncture appeared to be particularly effective in reducing hyperactivity and impulsivity in younger children with ADHD. These symptoms, often more prominent in younger populations, responded well to acupuncture when used alongside other treatments like medication.

  • Adolescents: For adolescents, acupuncture seemed to improve both hyperactivity and inattention, two symptoms that can often become more challenging as children grow older. This age group also benefited from acupuncture’s ability to reduce side effects from ADHD medications, such as irritability or sleep disturbances.

  • Combined Effects for Both Groups: When acupuncture was used in combination with pharmacotherapy, it also helped reduce side effects such as sleep problems and appetite loss in both children and adolescents. This could make it an attractive adjunctive treatment for those already on medication but experiencing undesirable effects.

  • Inattention and Conduct Problems: For both children and adolescents, acupuncture used in conjunction with either medication or behavioral therapy showed notable improvements in inattention and conduct problems—two of the most difficult symptoms of ADHD to manage.

  • Learning Difficulties and Psychosomatic Symptoms: Interestingly, the combination of acupuncture and medication provided significant improvements in learning difficulties, which are particularly relevant for children with ADHD. Meanwhile, acupuncture paired with behavioral therapy had a positive impact on psychosomatic symptoms, such as anxiety or stress, that often co-occur with ADHD.

Despite these promising results, the study also highlighted several limitations:

  • Study Quality Issues: The quality of the studies reviewed was often low, with many trials lacking the rigorous controls needed for high confidence in their results. For example, only a small number of trials used objective ADHD diagnostic tools, which could lead to biases in assessing acupuncture’s effectiveness.

  • Need for More Research: There is a lack of large-scale, high-quality randomized controlled trials (RCTs) comparing acupuncture with placebo treatments, which makes it hard to determine whether acupuncture’s effects are truly therapeutic or simply a placebo.

Conclusion: Is Acupuncture a Good Option for ADHD?

In short, and as is so often the way of evidence-based medicine, we still can’t say with absolute certainty one way or the other. These studies may show promise in improving hyperactivity, impulsivity, inattention, and conduct problems– in both children and adolescents. However, the evidence is not yet strong enough to recommend it as a primary treatment. While it may serve as a helpful complement to standard therapies, especially for those struggling with medication side effects or access to behavioral therapy, more research is needed to establish its effectiveness.

April 21, 2025