The demands of college can be high. Heavy class workloads can lead to late nights of cramming for exams and writing papers.
To power through the tug-of-war between getting a good night’s sleep or efficiently plowing through piles of homework, some otherwise-healthy young people turn to medications usually reserved for attention deficit hyperactivity disorder (ADHD).
ADHD is a common neurodevelopmental disorder. Although usually diagnosed in children, it can last well through adolescence and into adulthood.
But just how helpful and healthy are these ADHD “study drugs” for people who don’t even have the condition to begin with?
A new study out of the University of Rhode Island (URI) and Brown University suggests that these medications — like Adderall — might not help a healthy person’s cognition at all. In fact, the findings suggest that these drugs could even impair a young person’s memory.
The research was published in June in the journal Pharmacy.
Study co-authors Lisa Weyandt, PhD, professor of psychology at URI, and Tara White, PhD, assistant professor of research in behavioral and social sciences at Brown, studied 13 student volunteers from both universities, eliminating from the pool those who had already taken ADHD medications.
The students were observed during two 5-hour sessions and were given the typical 30 milligram dose of Adderall.
The drug was found to improve a student’s mood and focus, but this didn’t lead to an improvement in performance or the ability to perform well on tests for short-term memory and reading comprehension, for instance.
“The most surprising finding of our research was the drug effects — impairment — on working memory and no effects on reading comprehension and fluency,” said Weyandt. “We hypothesized that the drug would enhance neurocognition.”
This is the first multisite pilot study to look at the impact these kinds of medications can have on college students who don’t have ADHD or similar conditions.
The appeal of ADHD drugs
However, these drugs certainly have a use for those who need them.
The American Psychiatric Association reports that 5 percent of children have ADHD. But according to the Centers for Disease Control and Prevention, it’s thought that this percentage climbs higher depending on community samples.
While something like Adderall can be helpful for this percentage of the population, it’s believed that somewhere between 5 to a rather high 35 percent of college students who don’t have ADHD use drugs like Adderall, according to the Center on Addiction.
Adding to this perception that ADHD drug use runs high in healthy college students, a 2009 report from the National Survey on Drug Use and Health indicated that full-time college students between 18 and 22 were twice as likely as those who weren’t full-time to use Adderall nonmedically.
So, what is the appeal of ADHD medications for people who don’t have the condition?
John Piacentini, PhD, a clinical child and adolescent psychologist at the Resnick Neuropsychiatric Hospital at the University of California, Los Angeles (UCLA), told Healthline that healthy college students might commonly turn to these medications to cram at the last minute for exams and counter the effects of insufficient or poor sleep.
“They (the drugs) can provide extended energy and alertness for work or social activities, including partying, and the ‘high’ feeling associated with enhanced emotional and physiologic arousal,” he explained.
While he speculates that Adderall might be the most common, Dr. Jay Giedd, the division director of child and adolescent psychiatry at University of California, San Diego (UCSD) added that coffee, nicotine, Concerta, Ritalin, Vyvanse, Strattera, Provigil, ginkgo biloba, ginseng, L-theanine, tolcapone, and piracetam are other common substances used to combat ADHD that college students might turn to.
He stressed that peer pressure could be a major motivator for people to try some of these medications and substances even if they don’t have ADHD.
“They might have heard from others that it will make them smarter, get higher scores,” Giedd added. “The feeling [is] that others are doing it and if they don’t, they will be at a disadvantage.”
One size doesn’t fit all
But how do these drugs respond differently to the brains of people with and without ADHD? Weyandt said that she believes the human brain might need to be at a deficit of some kind for drugs like these to work. If not, they could have a detrimental effect.
She said that neuroimaging research with people who have ADHD has found reduced activity — think blood flow — in parts of the brain associated with the condition’s symptoms when off medication.
Once given the proper medication, the activity increases in these regions of the brain, and ADHD symptoms go down. So a person with ADHD has an improved ability to pay attention, and shows improved memory, planning, and response inhibition, she said.
“Since we found the drug did not improve neurocognition and may negatively influence working memory, this may suggest a deficit is needed to benefit from the medication,” she added. “Furthermore, we have found in other studies that students who report significant ADHD symptoms are more likely to misuse stimulants.”
Giedd stressed that a drug like Adderall is not “one size fits all.”
“For instance, about 70 percent of people with ADHD will respond reasonably well to a dextroamphetamine product like Adderall. But two out of three of those non-responders will then respond reasonably well to a methylphenidate product like Concerta. But only if you get the dose right,” Giedd stressed. “For some people, there’ll be no effect. For some people, it makes things worse. It takes time and a skilled clinician to get it right.”
He emphasized that this level of clinical care is for people who actually have ADHD, and that people who don’t have the condition but still take these drugs need to be leery.
“The ethics of giving stimulants to healthy youth are a very good reason large, well-controlled studies have not been done,” he said. “The results of the studies that are published are mixed, and it is hard to summarize because they use different medicines at different doses on different people with different outcome measures,” he said.
The next step
Stephen P. Hinshaw, PhD, professor in the department of psychology at the University of California, Berkeley and a professor of psychiatry and vice-chair for child and adolescent psychology at the University of California, San Francisco (UCSF) Weill Institute for Neurosciences, told Healthline that the dangers of stimulant use for people without ADHD are “not sufficiently understood.”
He added that Weyandt and White’s study echoes other findings that if a person already has a well-developed attentional control, stimulants don’t really provide much of a cognitive boost. They just aren’t necessary.
Giedd said that given how small this study is — just 13 people — the results are a “non-finding,” but “a first step in pursuing a more ambitious study.”
Moving forward, Weyandt said more work needs to be done. She asserted that this study is a pilot and that given how small this sample was, it will need to be replicated using a larger pool of people. She said that she and White plan to apply for federal funding to continue the research and that she would like to “investigate not only lab-based measures, but whether the drug has ‘real world’ effects on student presentations, exams, and so on.”
What should college students keep in mind as they head to campuses where ADHD medications are easily obtainable?
“Most students do not have sufficient information to accurately weigh the risks and benefits of using these medications in a non-physician-prescribed manner,” Piacentini added. “Importantly, students need to understand the potential risks associated with stimulant use, including sleep problems, weight loss, nervousness, as well as a number of more serious physical and psychological problems.”
For Weyandt, it’s important to raise awareness among college students about taking ADHD drugs given how many have no real “health concerns about taking them.”
“What’s also troubling is that most students obtain them from friends, family, and other illegal means and take doses they are able to purchase, obviously without monitoring by a physician,” she warned.