Brain chemistry discovery explains why Ritalin helps some more than others

A new study shows that the chemical wiring of our brains can explain why some people greatly improve concentration from stimulants like Ritalin, while others see little benefit — a discovery that could change the treatments for millions of attention disorders.

The clinical trial, published in the Proceedings of the National Academy of Sciences (PNAS), was co-led by the University of Maryland School of Medicine (UMSOM) and the National Institutes of Health (NIH), found that individual differences in brain chemistry, especially the balance of certain dopamine receptors, play an important role in determining the best stimulating drugs.

“We think the amount of dopamine-ritalin produced in a person will help us predict whether that individual will improve attention performance, but what we find is more complex.” “Instead, we found the types of dopamine receptors on brain cells, and the ratios found to be better predicting cognitive performance.”

These findings may help explain why nearly one-third of the 16 million U.S. adults diagnosed with attention deficit hyperactivity disorder (ADHD) respond poorly to stimulating drugs such as altarase (methylbenzoate) and Adderall.

The researchers used advanced brain scanning techniques to examine 37 healthy adults without ADHD who performed concentration and memory tasks after taking Ritalin or placebo on different days. They measured brain activity in these tasks, as well as levels of the two types of dopamine receptors D1 and D2, which helped regulate focus and attention.

Surprisingly, people with higher rates of D1 to D2 brain dopamine receptors performed better during baseline testing than D1 receptors compared to D1 receptors. But when it comes to improvements in Rislin, the opposite is true.

“Balanced signaling between D1 receivers and D2 receiver in the brain is needed for optimal brain function and variations in their relative signaling contributes both to differences in baseline cognitive performance and to why some people improve whereas others deteriorate their performance when given Ritalin,” explained study co-corresponding author Nora Volkow, MD, chief of the Laboratory of Neuroimaging at NIH’s National Institute of Alcohol Abuse and Alcoholism.

The study showed that participants with higher D1 receptor levels tended to have better baseline memory performance compared to D2 receptors, but altrust protein did not significantly improve, even though the drug increased dopamine levels. In contrast, people with relatively high D2 receptors while taking the medication will show greater improvement.

These findings have meaning in addition to the clinical treatment of ADHD. Researchers point out that the focus on the use of stimulators in healthy individuals without medical supervision to improve their cognitive performance – a practice known as “cognitive enhancement” or “smart medication” use.

Dr. Manza is also a researcher at UMSOM’s Kahlert Kahlert Institute, who is important to the brain’s impact on these drugs, so many people without ADHD are taking irritant drugs in an unprescribed way to try to improve their performance, which is important to us. “Our findings suggest that many of these people may not benefit from taking these drugs while risking using irritating drugs without medical supervision. ”

The team now plans to extend the study to people with clinical diagnosis of ADHD to examine their D1/D2 receptor ratios and determine whether people who respond poorly to drugs tend to have higher levels of D1 receptors.

“Determine if there is a subgroup of people with high levels of D1 receptors and determine if they are more likely to be resistant to stimulants like Ritalin,” said Mark T. Gladwin, dean of the University of Maryland School of Medicine. “This can help us work to personalize care for these people and seek more beneficial treatments, including cognitive behavioral therapy.”

These findings add to the growing evidence that personalized medical approaches (customized treatments based on individuals’ unique brain chemistry) can significantly improve the prognosis of neuropsychiatric disorders, which traditionally follow a suitable therapeutic model.

By revealing the neurobiological mechanisms that determine who responds best to stimulating drugs, the study opens the door to more precise diagnostic tools and potentially more effective, personalized therapeutic strategies for millions of noticed attention disorders.