ADHD drug improves cognitive decline in menopausal women

According to a new study, women experiencing difficulty with time management, attention, organization, memory, and problem solving - often referred to as executive functions - related to menopause may find improvement with a drug already being used to treat attention deficit hyperactivity disorder (ADHD). The study led by researchers at the Perelman School of Medicine at the University of Pennsylvania is the first to show that lisdexamfetamine (LDX) improved subjective and objective measures of cognitive decline commonly experienced in menopausal women. Results of the study are published online today in the journal Psychopharmacology.

"Reports of cognitive decline, particularly in executive functions, are widespread among menopausal women," said lead author, C. Neill Epperson, MD, professor of Psychiatry and Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania, and director of the Penn Center for Women's Behavioral Wellness. "There are approximately 90 million post-menopausal women living in the US alone, and with the average age of onset occurring at 52, the great majority of those women will live in the postmenopausal state for at least one-third of their lives. Therefore, promoting healthy cognitive aging among menopausal women should be a major public health goal."

The Penn-led team administered a once-daily dose of LDX for four weeks to 32 healthy, non-ADHD-diagnosed women between the ages of 45 and 60 experiencing difficulties with executive functions as a result of mid-life onset menopause, and as measured using the Brown Attention Deficit Disorder Scale (BADDS). All participants served as their own controls by being randomly assigned to cross-over to a placebo for an additional four weeks.

The researchers found a 41 percent overall improvement in executive functions for women receiving LDX, compared to a 17 percent improvement when taking placebo medication. There were also significant improvements in four out of the five subscales for women taking LDX: organization and motivation for work; attention and concentration; alertness, effort, and processing speed; and working memory and accessing recall.

While psychostimulants such as LDX are primarily marketed for the treatment of ADHD, they have been successful in treating cognitive complaints in some patients including postmenopausal women. They work by promoting the release of dopamine, which is impaired in ADHD and other disorders characterized by executive function problems.

"Although we observed that short-term use of LDX was well tolerated and effective in several subjective and objective areas, long-term studies of menopausal women receiving LDX are needed, similar to those conducted for ADHD patients," said Epperson. "It is also important for clinicians to confirm that a woman's complaints of worsening memory are in the executive function domains, are temporally related to the transition to menopause, and are not indicative of some other pathological cognitive impairment before prescribing a trial of LDX."