Medication Resistant Deficits in ADHD

“Possible Medication-Resistant Deficits in Adult ADHD”

Maruta, J., Spielman, L.A., Tseretopoulos, I.D., Hezghia, A., Ghajar, J.

This article reports on neurocognitive and visual tracking performance of adult subjects with ADHD on and off stimulant medication in an effort to clarify the precise attention impairments seen in this population.  Twenty-three adults with ADHD and forty-six two-for-one matched normal controls were assessed on a variety of neurocognitive and visual tracking measures.  Adult ADHD subjects were tested on and off their prescribed stimulant medication, and results of test performance were compared using paired t test statistical analysis.  Tests included the Attention Network Test (ANT), the Spatial Span subtest of the Wechsler Memory Scale, a circular visual tracking test, and a reaction time test.  None of the ANT metrics or visual tracking tests demonstrated differences between controls and ADHD patients on medication.   However, significant differences were seen in the spatial span tests and in the reaction time tests when they were administered after attention-demanding tasks.  These results suggest that for adults with ADHD, stimulant medications can improve visual tracking, reaction time and alerting and orienting, but they do not seem to improve visual-spatial working memory or susceptibility to cognitive fatigue.   These findings are worthwhile considering when advising patients about the benefits of taking stimulant medication insofar as some aspects of cognitive functioning may not improve as dramatically as others do.

Posted by Anthony L. Rostain, MD MA

Anthony L. Rostain is Chief and Chair, Department of Psychiatry, of Cooper University Health Care.  He is also Professor of Psychiatry and Pediatrics.  Dr. Rostain's clinical focus is “lifespan neurodevelopmental psychiatry,” which includes patients of all ages with attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, Tourette syndrome, learning disabilities (verbal and nonverbal), and related social learning disorders.  Dr. Rostain's research interests focus on improving clinical outcomes for patients across the lifespan with neurodevelopmental disorders, and on creating effective service systems for these patients and their families.  He is former President of APSARD (American Professional Society of ADHD and Related Disorders), and formerly on the Program Committee for, to which he remains contributor and advisor.

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