ADHD

Updated 29 December 2015

ADHD drug may help during menopause

A small study suggests that Vyvanse might help with concentration and thought organisation in menopausal women.

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A drug marketed for attention deficit hyperactivity disorder might improve memory and concentration problems associated with menopause, a new, small study suggests.

Vyvanse (lisdexamfetamine), a stimulant, is usually prescribed to children and adults with ADHD. But researchers found it also may help to improve menopausal women's "executive function" - brain activities such as memory, reasoning, multitasking, planning and problem-solving.

"We always hear about hot flashes, irregular periods and insomnia classically linked to menopause, but there are other symptoms equally annoying but less talked about," said Dr. Sheryl Ross, an obstetrician-gynaecologist at Providence Saint John's Health Center in Santa Monica, Calif., who was not involved in the study. "Cognitive changes happen in the majority of women going through menopause, and memory loss, poor concentration, a short attention span and other cognitive changes can be disruptive and frustrating."

The study was funded by Shire, the drug's maker, and the U.S. National Institutes of Health. The findings were published online June 11 in the journal Psychopharmacology.

The study authors randomly gave 32 women 40 to 60 milligrams of Vyvanse or a placebo daily for four weeks. All were between ages 45 and 60, were either going through or just finishing menopause, and had complained of difficulties with executive function.

None had a history of ADHD, but all scored high enough on an assessment of symptoms to show they were experiencing executive function difficulties at the time of the study. They also underwent several tests related to memory and attention.

After four weeks, the women had a two-week break before the groups switched. Women who got a placebo the first time now received the real medication and vice versa for another four weeks.

The researchers found that the women had better scores on their symptoms assessments while taking the medication. They also scored better on one of the three memory and concentration tests while taking Vyvanse.

Another women's-health expert stressed the need for more studies and more treatment options for menopausal women.

"We need more research before changing our clinical practice, but it is encouraging that we are looking at other treatments for a variety of cognitive, mood and physical symptoms that are present during perimenopause and menopause for women," said Dr. Nicole Cirino, director of women's mental health and wellness at Oregon Health & Science University. "It's especially exciting to see this research for women who cannot tolerate hormone replacement therapy," added Cirino, who was not involved in the study.

Many women use hormone replacement therapy for menopausal symptoms, but how much it can help mental functioning is controversial, said Dr. Kevin Ault, an obstetrician-gynaecologist and professor at the University of Kansas Medical Center. The evidence has not clearly shown that it does or does not help.

Not every woman is comfortable taking hormone replacement therapy or cannot take it due to other medical complications, Ross noted. "Even though this is a small study, it shows that other medications can be safe and effective in treating annoying cognitive side effects of menopause," she said.

While the women in the study were taking the medication, their blood pressure and heart rate increased but stayed in the normal range overall. The study authors did not report other major side effects.

"One of the problems with having a small study like this is that you're not going to see the big picture with side effects," Ault said.

Known side effects of Vyvanse include trouble sleeping, nervousness, dizziness, skin numbness, irregular heartbeat, headaches, nausea, vomiting, weight loss and loss of appetite, said Ross.

There are also individuals who should not take Vyvanse based on their health history, Cirino said, such as those with a history of heart conditions or a history of addiction or dependence.

"It is a psychostimulant that is a controlled substance, so it has to be given to the right candidate," Cirino said. "These can be addictive substances, especially if not carefully monitored, and they can worsen certain mood conditions, such as anxiety disorder, bipolar disorder or psychotic disorder."

Ideally, she said, women would wean off the medication once past menopause.

A 30-day supply of Vyvanse is estimated to cost between $200 and $250 without insurance. It is available through major pharmacies but has not been approved by the Food and Drug Administration for use in menopausal women.

Read more:

Premature menopause may cause mental decline

Hormonal pills not ideal for long-term use

 

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Dr. Shabeer Ahmed Jeeva is a specialist psychiatrist who has been practicing child and adult psychiatry for 30 years. He has vast experience in treating ADHD, and is also an ADHD patient himself. Dr. Jeeva trained and practiced in Canada as a child and adult psychiatrist and had lived there for 25 years. He had attended medical school at the Royal College of Surgeons in Dublin, Ireland (1970-1976). His professional experience and accreditation includes: Psychiatric residency at the University of Ottawa (Canada), Child Psychiatry fellowship at the University of Ottawa (Canada), Diploma in Psychiatry at the University of Ottawa (Canada), and Fellow of the Royal College of Physicians in Canada.

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