Is caffeine good for adhd
Is This Natural Treatment Safe & Effective?
Coffee, tea, sodas, energy drinks, chocolate — many of us consume caffeine throughout the day for a quick, temporary energy surge. Caffeine stimulates the nervous system and boosts dopamine production — both of which help the body with movement, attention, and focus.
In the context of attention deficit hyperactivity disorder (ADHD or ADD), treatments often include stimulant medication, which has a similar effect. But is caffeine a viable option to help manage ADHD symptoms? Is it safe for adults and children? What about side effects? Here, we break down the most common effects of caffeine, its safety, and the most recent research available.
How does caffeine affect the brain and body?
Caffeine affects each individual differently. While most experts deem moderate consumption of this natural stimulant safe1, too much caffeine may result in side effects that range from nervousness, anxiety, rapid heartbeat, and upset stomach to restlessness, migraines, sleeplessness, and muscle tremors.
In addition to alertness and increased focus, caffeine may help weaken headaches, boost memory, and even ward off certain diseases, including cancers, Alzheimer’s2, and Parkinson’s3.
“In a general sense, caffeine does tend to improve our performance,” noted Ari Tuckman, Psy.D., M.B.A., the author of More Attention, Less Deficit: Success Strategies for Adults With ADHD (#CommissionsEarned) and Integrative Treatment for Adult ADHD: A Practical, Easy-to-Use Guide for Clinicians (#CommissionsEarned) 4, in a video5 for ADDitude. He adds, however, that those taking ADHD medication may report feeling extra jittery after consuming too much caffeine. And when certain medications combine with caffeine, they may interact poorly.
WATCH THE ADHD & CAFFEINE VIDEO BELOW TO LEARN MORE
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How does caffeine affect ADHD?
The effects of caffeine consumption on ADHD remain largely anecdotal. The stimulant calms some people, while increasing anxiety in others. However, many parents and adults with ADHD, (and some studies) report light to moderate caffeine use as a way to help boost focus and concentration.
Tuckman, however, notes that patients taking stimulant medication for ADHD tend to crave caffeine less. “The amount of caffeine you’d need to consume to affect ADHD would probably cause agitation,” said Larry Silver, M.D.6, clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C., and director of training in child and adolescent psychiatry at Georgetown University School of Medicine. “I don’t recommend drinking caffeinated beverages [or taking caffeine-containing pills] as a way to treat ADHD.”
How much caffeine is safe?
The Mayo Clinic7 reports 400 milligrams of caffeine each day is safe for an adult; that’s about four cups of coffee. In children, the maximum caffeine intake varies by age, with the 4- to 6-year-old age range at 45 milligrams per day, and 85 milligrams (roughly one 8-ounce cup) for a 10 to 12-year-old. Pregnant women or those trying to conceive should limit caffeine to a maximum of 300 milligrams per day.
What does the research say about treating ADHD with caffeine?
Researchers studying caffeine in relation to ADHD is nothing new, but the actual body of research remains relatively small and inconclusive.
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A 2011 study8 published in the Journal of Medical Hypotheses and Ideas reports tea consumption may prove effective to help treat ADHD in adults. Another study9 that same year found a significant improvement in attention deficit disorder in rats who consumed caffeine.
A 2014 review10 in the journal Psychopharmacol called for further investigation of caffeine’s therapeutic potential as a therapy or an adjunctive agent in ADHD. And a 2013 study11 published in European Neuropsychopharmacology suggests that caffeine could be useful as a treatment, as it appears to normalize levels of dopamine and improve attention in people with ADHD.
What’s the bottom line on ADHD and caffeine?
In 2017, we received more than 4,000 responses to our ADDitude survey12 from caregivers and adults navigating ADHD treatment. When asked about dietary habits, one respondent reported: “We try to reduce sugars, caffeine (chocolate), and increase protein,” while another noted that “caffeine is good, but not excessive amounts.” And yet another responded that she uses fish oil, caffeine, vitamin D, and exercise to manage symptoms.
In other words, it appears there is no single best practice being recommended by medical professionals or followed by patients.
The bottom line on caffeine use: While one person may manage symptoms with a cup of coffee in the morning, another may not. What works best isn’t always the treatment recommended by their doctors or used by the most people.
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1 Melanie A. Heckman, Jorge Weil, Elvira Gonzalez De Mejia. “Caffeine (1, 3, 7‐trimethylxanthine) in Foods: A Comprehensive Review on Consumption, Functionality, Safety, and Regulatory Matters.” Journal of Food Science (2010): https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-3841.2010.01561.x
2“Caffeine’s Effect on Memory, Cognition, and Alzheimer’s.” Caffeine Informer. Accessed December 20, 2018. https://www.caffeineinformer.com/bad-memory-drink-more-caffeine
3Kumar, Prakash M., Swe Swe Thet Paing, HuiHua Li, R. Pavanni, Y. Yuen, Y. Zhao, and Eng King Tan. “Differential Effect of Caffeine Intake in Subjects with Genetic Susceptibility to Parkinson’s Disease.” Nature News. (November 02, 2015.) Accessed December 20, 2018. https://www.nature.com/articles/srep15492
4“More Attention, Less Deficit.” More Attention, Less Deficit. Accessed December 20, 2018. http://adultadhdbook.com/
5ADDitude Magazine. “ADHD and Caffeine: Is It An Effective Alternative Treatment?” YouTube. (August 17, 2011.) Accessed December 20, 2018. https://www.youtube.com/watch?v=nPf2FYryyDU
6Larry Silver. “Caffeine as a Treatment.” ADDitude. (July 07, 2017.) Accessed December 21, 2018. https://www.additudemag.com/caffeine-as-a-treatment/.
7“Caffeine: How Much Is Too Much?” Mayo Clinic. (March 08, 2017.) Accessed December 21, 2018. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/art-20045678.
8Kezhi Liu, Xuemei Liang, Weihong Kuang. “Tea Consumption Maybe an Effective Active Treatment for Adult Attention Deficit Hyperactivity Disorder (ADHD).” NeuroImage. (February 01, 2011.) Accessed December 21, 2018. https://www.sciencedirect.com/science/article/pii/S0306987710003531?via=ihub.
9Miguel Caballero, Fabiana Núñez, Siobhán Ahern, Maria L. Cuffí, Lourdes Carbonell, Silvia Sánchez, Víctor Fernández-Dueñas, Francisco Ciruela. “Caffeine Improves Attention Deficit in Neonatal 6-OHDA Lesioned Rats, an Animal Model of Attention Deficit Hyperactivity Disorder (ADHD).” NeuroImage. (February 27, 2011.) Accessed December 21, 2018. https://www.sciencedirect.com/science/article/abs/pii/S0304394011002412.
10K. Ioannidis, S. R. Chamberlain, and U. Müller. “Ostracising Caffeine from the Pharmacological Arsenal for Attention-deficit Hyperactivity Disorder–was This a Correct Decision? A Literature Review.” Current Neurology and Neuroscience Reports. (September 2014.) Accessed December 21, 2018. https://www.ncbi.nlm.nih.gov/pubmed/24989644.
11Pablo Pandolfo, Nuno J. Machado, Attila Köfalvi, Reinaldo N. Takahashi, Rodrigo A. Cunha.”Caffeine Regulates Frontocorticostriatal Dopamine Transporter Density and Improves Attention and Cognitive Deficits in an Animal Model of Attention Deficit Hyperactivity Disorder. ” NeuroImage. (May 04, 2012.) Accessed December 21, 2018. https://www.sciencedirect.com/science/article/pii/S0924977X12001071.
12Devon Frye, and Anni Layne Rodgers. “Special Report: How You Are Treating ADHD or ADD Today.” ADDitude. (September 27, 2018.) Accessed December 21, 2018. https://www.additudemag.com/adhd-treatment-options-caregivers-adults-survey-results/.
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How Does Caffeine Affect ADHD
Caffeine and ADHD
Caffeine is found in coffee, tea, and chocolate to name a few, and it’s one of the world’s favorite drugs. But what impact does it have on your brain? The right amount of caffeine can help you focus, but too much might make you jittery, anxious, or irritable.
Because caffeine is so prevalent, it’s important to know how it affects individuals with ADHD.
Caffeine is considered a stimulant. It stimulates the body’s central nervous system, and boosts the brain’s production of a neurochemical known as dopamine, which controls the ability to focus and maintain concentration. This stimulation can cause a person to feel energized and not to feel the effects of fatigue as strongly.
Sometimes the effect can be negative, however. For example, people who have trouble sleeping can experience further sleep disturbances or insomnia due to caffeine.
Sleep deprivation can cause ADHD-like symptoms. These include:
- increased forgetfulness
- trouble focusing or sitting still
- difficulty controlling emotions
Sleep deprivation makes these symptoms worse in people with ADHD.
People with ADHD should only use caffeine in the morning and should avoid consumption of coffee, tea, soda, or chocolate in the evening or late at night.
Reduced blood flow to the brain
Caffeine is also a vasoconstrictor. That means it makes blood vessels smaller and reduces blood flow. This reduced blood flow is why caffeine helps headaches. Amphetamine medications used to treat ADHD also make blood vessels smaller. Caffeine may have some effects similar to those of common ADHD medications.
Although the exact reason is unknown, reduced blood flow may help treat ADHD by reducing the activity of brain regions that are overactive, allowing them to better function and cooperate with the rest of the brain.
Dopamine levels in the brain have to be within a very narrow margin in order for a person to be able to focus on their work. But in ADHD, dopamine levels are too low. Stimulant chemicals such as caffeine or amphetamines tend to increase dopamine levels.
For most people, adding stimulants will push dopamine levels too high, causing agitation and anxiety. But for people with ADHD, adding stimulants can get the levels just right. A few cups of coffee throughout the day can make a real difference.
Some studies have found that caffeine can boost concentration for people with ADHD. Since it’s a stimulant drug, it mimics some of the effects of stronger stimulants used to treat ADHD, such as amphetamine medications.
However, caffeine alone is less effective than prescription medications. Adults can use caffeine safely for their ADHD, but caffeine consumption can actually harm children and teens.
When caffeine and amphetamine medications like Adderall (amphetamine and dextroamphetamine) combine, they cause an effect called synergy. Synergy occurs when two drugs have additive mechanisms of action, making their combined effect more powerful. Caffeine makes amphetamines more effective, so a person taking Adderall, for example, would likely feel a stronger impact, including greater side effects.
The Mayo Clinic defines heavy caffeine use as four or more cups of coffee per day, or 500 to 600 mg. Too much caffeine may cause:
- rapid heartbeat
- muscle shakes or tremors
- upset stomach
Since medication combinations are very hard to control, a person taking both amphetamines and caffeine will also get a double dose of their side effects. Both drugs can cause anxiety, difficultly sleeping, nausea, and stomach pains.
If you’re experiencing anxiety or difficulty sleeping, you may be ingesting too much caffeine. Make sure to always take both your medication and caffeine with food to control stomach pains. Talk to your doctor if nausea persists.
Although emerging research is finding that ADHD has a genetic component, it’s also finding that ADHD is not just one thing. Rather, people with mutations at any number of points in their genetics might get classified with ADHD. For developing children, some brain regions might develop at different rates than the other regions that regulate them. Because ADHD has different causes, treatments can affect people differently.
Some people find that caffeine helps their ADHD, while others find that it doesn’t offer any benefit at all, or even makes their focus worse. Pay attention to your body and work with your doctor to find out what is best for you.
ADHD: caffeine can counter attention deficit
A recent review shows that caffeine can effectively counter attention deficit, improve learning and memory in animals with Attention Deficit Hyperactivity Disorder (ADHD). Review published in Nutrients .
Practical implications of the work
Caffeine can be used to treat people with ADHD whose symptoms are mainly attention deficit, but researchers will need to confirm these results in humans.
Data on the effect of caffeine on hyperactivity and impulsivity has been mixed, suggesting that caffeine may not be appropriate for people with ADHD with these specific symptoms. Study co-author Javier Vázquez from the Universitat Oberta de Catalunya, Spain, explains in detail why they decided to study the effects of caffeine.
“The therapeutic arsenal for relieving the symptoms of ADHD is limited, and there is a degree of controversy surrounding the use of certain types of drugs and stimulants, especially in childhood and adolescence. That's why it's useful to study the effectiveness of other substances like caffeine."
Modern treatments for ADHD
ADHD is a mental illness that affects children and adults. ADHD is characterized by difficulty maintaining attention, hyperactivity or restlessness, and impulsive behavior. There are three main types of ADHD, with the most common subtype characterized by people showing all three symptoms. The other two types include symptoms of inattention without hyperactivity, or hyperactivity and impulsivity without inattention. Commonly used drugs for ADHD include stimulants such as methylphenidate (Ritalin, Concert) and amphetamines.
Although it is a common misconception that stimulants can increase hyperactivity in people with ADHD, drugs such as Ritalin have a calming effect on these people.
Abnormal levels of brain chemicals or neurotransmitters, including dopamine, serotonin, and norepinephrine, are associated with ADHD symptoms. Stimulants such as methylphenidate tend to renormalize the levels of these chemical messengers, in part by increasing levels of dopamine, a neurotransmitter that controls the ability to focus. This may explain the counterintuitive calming effect of these drugs on people with ADHD.
While evidence suggests that long-term use of stimulants such as Ritalin is safe and beneficial for treating ADHD symptoms, some people with ADHD may be less able to tolerate these drugs.
ADHD and caffeine
Caffeine differs from other stimulants in its mechanism of action and may provide an alternative to the ADHD stimulants currently in use. Lidia Zylowska, University of Minnesota psychiatrist and author of The Mindfulness Recipe for Adults with ADHD, said:0005
"Many adults with ADHD self-medicate with caffeine, and knowing about its effects on people with ADHD would help us understand who and how caffeine may or may not benefit. "
Dr. Zylowska elaborated on why caffeine can be a good alternative to drugs in some cases:
them. We need more tools to treat ADHD.”
Studies on the use of caffeine in patients with ADHD have been small, limited, and largely outdated, with most of them conducted in animals.
Study materials and results
In this study, scientists summarized the results of 13 animal studies conducted since 2005 that evaluated the effects of caffeine on ADHD symptoms. The review found that caffeine treatment reduces attention deficits and other cognitive functions seen in ADHD. In particular, caffeine treatment improved sense of smell, attention, learning, memory retention, short-term memory, and working memory in adolescent and adult animals with ADHD-like symptoms. In addition, caffeine treatment did not lead to changes in body weight or blood pressure, which is one of the problems associated with stimulant drugs. In contrast to the effect of caffeine on cognition, data on the effect of caffeine on hyperactivity has been mixed. Moreover, age and gender influenced the effects of caffeine on hyperactivity.
Only one study evaluated the effect of caffeine on impulsivity. The results of scientific work have shown that caffeine reduces impulsivity in the short term, but increases behavior after chronic treatment. The lack of a clear effect of caffeine on hyperactivity and impulsivity in ADHD suggests that caffeine may only be useful in treating people whose symptoms are mainly related to attention deficit.
Studies have also shown that caffeine treatment renormalizes brain markers of ADHD. For example, caffeine increased dopamine and serotonin levels, which are lower in people with ADHD.
Use of caffeine to treat ADHD
The ability of caffeine to reduce cognitive symptoms and improve brain performance in animals suggests that it may be used to treat symptoms of ADHD in humans. However, the study authors note that further research is needed to confirm these findings before caffeine can be used to treat ADHD.
Dr. Mark Stein said, "Human studies show an average beneficial effect of caffeine on ADHD symptoms, with great variability in response, over time, and tolerability issues such as poor sleep." He also noted that most people with ADHD need "more intense and effective interventions."
“For those with subclinical ADHD or mild symptoms, caffeine can play a role. However, caution should be exercised when generalizing safety and efficacy data from animal studies to people with ADHD who have both symptoms and impairments in their functioning,” concluded Dr. Mark Stein.
Related article: Diets for ADHD.
Sugar and ADHD: what's the connection?
Attention deficit/hyperactivity disorder (ADHD) is a common neurological disorder affecting more than 6.1 million people in the United States (1). It has been suggested that certain dietary factors, such as high sugar intake, may influence ADHD.
Although some studies have shown that sugar consumption may negatively affect ADHD symptoms, there is no definitive conclusion.
In this article, we'll take a look at what current science says about the relationship between ADHD and sugar, and what therapies are available to manage the symptoms.
The Science of Sugar and ADHD
Extensive research has been done on the correlation between sugar consumption and the risk and symptoms of ADHD. While some research suggests that sugar can negatively impact ADHD, studies have shown conflicting results.
In a 2019 systematic review and meta-analysis of studies (2), researchers reviewed scientific literature on the relationship between diet and ADHD.
The results of the analysis showed that an "unhealthy" diet, such as High consumption of refined sugar or saturated fat increases the risk of ADHD . A healthy diet, such as plenty of fruits and vegetables, has a protective effect.
A 2020 review of studies (3) confirmed an association between sugar and soft drink consumption and ADHD symptoms.
The results showed that increased consumption of sugar and sugar-sweetened beverages caused an increase in ADHD symptoms.
Although the results of the above studies show that there is an association between sugar consumption and ADHD, not all studies support this. In one 2019 study (4), researchers examined whether sucrose intake was associated with the development of ADHD.
The results of this study suggest that among children aged 6 to 11 years increased intake of sucrose was not associated with an increased risk of ADHD . Although sucrose is only one type of sugar, these results may show that only Certain types of sugar affect ADHD.
It has also been suggested that artificial additives, often found in foods high in sugar, may negatively impact ADHD symptoms. However, much of the research on this topic appears to be biased or erroneous.
For example, a 2015 meta-analysis (5) analyzed 24 studies on artificial food coloring and 10 additional studies on dietary restriction in ADHD.
Although food restriction has proven beneficial for some children with ADHD, available research on the association between artificial supplements and ADHD has been weak.
The Mayo Clinic does note that certain food colors and preservatives may increase hyperactive behavior in some children (9). Avoid products with these colors and preservatives:
- sodium benzoate, commonly found in sodas, salad dressings, and fruit juice products.
- FD&C Yellow No. 6 (sunset yellow), which is found in breadcrumbs, cereal, candy, frosting, and soft drinks.
- D&C Yellow No. 10 (quinoline yellow), which is found in juices, sherbets, and smoked haddock.
- FD&C Yellow No. 5 (tartrazine), which is found in foods such as pickles, cereal, muesli bars, and yogurt.
- FD&C Red No. 40 (Allura red), which is found in soft drinks, children's medicines, gelatin desserts, and ice cream.
ADHD and caffeine
Research on ADHD and caffeine is extensive, from the effect of caffeine during pregnancy on ADHD risk to the effect of caffeine on ADHD symptoms.
Several scientists in their 2020 paper "Caffeine Induces Neurobehavioral Effects by Modulating Neurotransmitters" suggested that caffeine intake may help reduce symptoms of ADHD. (7)
Other studies reported that caffeine had neuroprotective effects in animal models by protecting dopaminergic neurons.
In addition, caffeine interacts with the dopaminergic system resulting in improved neurobehavioral performance in animal models of depression or attention deficit hyperactivity disorder (ADHD).
Glutamatergic receptors have been found to influence the neurobiological effects of caffeine. In addition, it turned out that caffeine suppresses inhibitory (GABAergic) activity and modulates GABA receptors . Research has also shown that the modulation of these neurotransmitters leads to neurobehavioral effects.
Interestingly, adolescents with ADHD consume more caffeine throughout the day (8). Increased caffeine intake is likely related to its positive effect on symptoms, but more research is still needed.
ADHD and binge eating
There are few studies on the relationship between ADHD and binge eating.
One 2010 review (6) analyzes the relationship between ADHD and binge eating, which may extend to sugar addiction.
In this review, the author explains that certain behaviors that are associated with ADHD, such as impulsivity or inattention, can contribute to overeating. In turn, overeating can be a symptom of a more serious food craving.
However, it is important to note that research on the relationship between these conditions is very limited.
Treatment options for ADHD often include medications, therapies, and behavioral interventions to reduce the symptoms of the condition.
Medications for ADHD
Medications are one of the most effective treatments for ADHD and are often effective even when used alone. Medications for ADHD may include:
- Stimulants. The most commonly prescribed central nervous system (CNS) stimulants, such as Adderall and Concerta. CNS stimulants help improve concentration and attention by increasing levels of dopamine and norepinephrine in the brain.
- Non-stimulants. When stimulants are not suitable, non-stimulant drugs such as Strattera and Pamelor (Nortriptyline) are prescribed. Non-stimulants help increase the level of norepinephrine in the brain, which improves memory and attention.
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Therapy is an option for people who suffer severely from ADHD symptoms and need mental health support. Therapy for ADHD may include:
- Psychotherapy. Psychotherapy can be helpful for both children and adults with ADHD. For example, cognitive behavioral therapy can help you analyze and change thoughts or behaviors that may make symptoms worse.
- Behavior and social therapy. Behavioral therapy helps learn how to correct ADHD behaviors, while social skills training can help improve problematic ADHD behaviors.
- Support groups. Although support groups often target parents of children with ADHD, adults with ADHD can also benefit from peer support. These groups may also suggest other resources for treating and managing ADHD.
Behavioral intervention can help ease the management of some of the most devastating symptoms of ADHD. These interventions may include:
- Identifying a trigger. Certain triggers can cause an increase in ADHD symptoms. Once you can identify these triggers, you can make lifestyle changes to reduce the chance of episodes.
- Scheduling. While a schedule is especially helpful for children with ADHD, most adults also benefit from having a set schedule. Scheduling your wake and sleep times, meals, and more can help reduce the stress of making last-minute decisions.
- Organization of life. With ADHD, it can be difficult to keep track of responsibilities such as work, school, and others. By organizing your personal and professional life, you can easily cope with tasks.
ADHD Medical Device
A US prescription-only device called the Monarch Trigeminal External Stimulation System (eTNS) for patients 7 to 12 years of age who are not taking prescription medications for ADHD, and is the first non-drug treatment for ADHD to receive marketing approval from the FDA.
"This new device offers a safe, non-drug treatment option for ADHD in pediatric patients through the use of mild nerve stimulation," said Carlos Peña, Ph. D., director of the Department of Neurology and Medicine.
Monarch eTNS is intended for home use with parental supervision. The cell phone-sized device generates a low-level electrical pulse and is connected via a wire to a small patch to be attached to the patient's forehead. The system provides low-level electrical stimulation to the branches of the trigeminal nerve, which sends therapeutic signals to parts of the brain thought to be involved in ADHD. While the exact mechanism of eTNS is not yet known, neuroimaging studies have shown that eTNS increases activity in areas of the brain known to be important in regulating attention, emotion, and behavior.
The effectiveness of the Monarch eTNS system in the treatment of ADHD has been demonstrated in clinical trials comparing eTNS as a single treatment or monotherapy with a placebo device. The study involved 62 children with moderate to severe ADHD who used either eTNS therapy every night or a placebo device at home for four weeks.