ADHD meds show menopause brain fog promise

ADHD medications may improve self-reported menopause brain fog, new research suggests.

The findings suggest that medicines used to treat ADHD could help women experiencing difficulties with concentration, memory and organisation during the menopause transition.

However, the evidence is preliminary.

Researchers say larger studies are needed to establish whether these medications are safe and effective for menopause-related cognitive symptoms before they can be recommended.

Jennifer Tat, lead author of the review from the University of Tennessee Health Science Center in Memphis, said: “Many women at perimenopause notice changes in focus, memory, and organisation that look a lot like ADHD, and the two can be hard to tell apart.

“Our review found early signs that ADHD medications may help women feel more on top of their daily lives.

“While it’s too early to recommend these medications, a quick screen for ADHD symptoms is a simple step that could help women get the right care.”

The review examined two ADHD medications: lisdexamfetamine (LDX), a stimulant, and atomoxetine (ATX), a non-stimulant.

It included research involving women aged 45 to 60 whose last menstrual period was less than 10 years ago.

Both medications were associated with significant improvements in self-reported executive function, which includes skills such as planning, concentrating, remembering information and managing everyday tasks.

Women taking either medication reported improvements on the Brown Attention Deficit Disorder Scale compared with those receiving a placebo, an inactive treatment.

Brain imaging findings from a subset of women taking lisdexamfetamine provided further support for the results.

However, neither medication showed significant improvements on most objective cognitive measures, including tests of working memory and sustained attention.

This distinction is important. Although women reported feeling better able to manage everyday tasks, the review did not establish corresponding improvements in measured cognitive performance.

The scoping review examined whether ADHD medications could offer a non-hormonal treatment option for cognitive difficulties during perimenopause.

An estimated 44 to 60 per cent of perimenopausal women report cognitive changes, including forgetfulness and difficulty concentrating, commonly described as brain fog.

During the menopause transition, declining and fluctuating oestrogen levels affect chemical signalling in the brain, including pathways involved in attention and cognitive function.

These changes can contribute to symptoms resembling ADHD, including difficulties with working memory, attention and processing speed.

The review also found that more severe ADHD symptoms were associated with a greater burden of perimenopausal symptoms.

However, evidence about whether having a formal ADHD diagnosis affects physical and psychological menopause symptoms was inconsistent.

Researchers suggested the medications may improve perceived executive function by acting on brain signalling pathways affected during the menopause transition.

The findings do not establish ADHD medications as effective treatments for menopause-related cognitive difficulties.

No medication is currently approved by the US Food and Drug Administration specifically for menopausal brain fog.

Dr Stephanie Faubion, medical director of The Menopause Society, said: “For most women, brain fog at menopause is a temporary condition that does not lead to permanent cognitive changes or dementia.

“However, it can last long enough to disrupt work and daily routines and cause significant stress and anxiety.

“That’s why studies like this are important in helping to identify additional options for symptoms.”