Health
What to Know About Adderall, Ritalin and Other Prescription Stimulants
Health Secretary Robert F. Kennedy Jr. has often criticized prescription stimulants, such as Adderall, that are primarily used to treat attention deficit hyperactivity disorder.
“We have damaged this entire generation,” he said last year during a podcast, referring to the number of children taking psychiatric medications. “We have poisoned them.”
In February, the “Make America Healthy Again” commission, led by Mr. Kennedy, announced plans to evaluate the “threat” posed by drugs like prescription stimulants.
But are they a threat? And if so, to whom?
Like many medications, prescription stimulants have potential side effects, and there are people who misuse them. Yet these drugs are also considered some of the most effective and well-researched treatments that psychiatry has to offer, said Dr. Jeffrey H. Newcorn, the director of the Division of A.D.H.D. and Learning Disorders at the Icahn School of Medicine at Mount Sinai in New York.
Here are some answers to common questions and concerns about stimulants.
What are prescription stimulants?
Prescription stimulants are drugs that help change the way the brain works by increasing the communication among neurons.
They are divided into two classes: methylphenidates (like Ritalin, Focalin and Concerta) and amphetamines (like Vyvanse and Adderall).
The drugs are most often prescribed to treat A.D.H.D., but they’re also used for conditions like narcolepsy or a binge eating disorder. Sometimes they are also used off-label, for treatment-resistant depression, or catatonia, a syndrome that can cause a patient to move in unusual ways, become immobile or stop talking.
The medications work by amplifying the activity of the neurotransmitters dopamine and norepinephrine in the nerve cells of the brain. Dopamine plays a role in creating the desire for something and the motivation to get it, while norepinephrine can increase alertness and make it easier to focus.
People with A.D.H.D. may have a deficit of both of these chemicals, so when they use stimulants it essentially helps “even them out,” said Dr. Anthony L. Rostain, chairman of the department of Psychiatry and Behavioral Health at Cooper University Health Care, which is based in Camden, N.J.
For some users, the effects are profound. “It’s like glasses for poor vision,” Dr. Rostain said.
Are stimulants always used to treat A.D.H.D.?
No.
Not everyone who has been diagnosed with A.D.H.D. takes stimulants. There are also non-stimulant medications, like Strattera (atomoxetine). And some people don’t require any medication at all.
Other interventions, such as behavioral therapy, parent training, school supports, and lifestyle changes to regulate sleep and exercise, are important — regardless of whether someone needs medication or not.
How many people are taking them?
The use of prescription stimulants has been on the rise since 2012, particularly among adults, and has sharply increased in recent years among women as well as patients ages 20 to 39.
In 2023, an estimated 6 percent of adults had a current diagnosis of A.D.H.D. and about one-third of those patients reported taking prescription stimulant medication, according to an analysis from the Centers for Disease Control and Prevention.
In children and adolescents, however, the number of stimulant prescriptions has been more stable in recent decades.
Overall, it is estimated that about 5 percent of children in the U.S. are currently prescribed medication for A.D.H.D. (Not 15 percent, the number stated by Mr. Kennedy during his confirmation hearing in January.)
A study published in February found that prescriptions actually declined among children after the pandemic began.
How often are prescription stimulants misused?
Government drug use surveys show that in 2022, among people 12 and older, 1.5 percent reported misusing prescription stimulants in the past year — taking the drugs without a doctor telling them to do so, or not in the manner they were prescribed. Sometimes people are aspiring to be more productive or to stay awake, but the drugs are also used recreationally, and can produce a high by swallowing, smoking or snorting the medication — or injecting it into the bloodstream.
Young adults ages 18 to 25 had the highest rates of misuse: 3.7 percent.
Among adolescents 12 to 17, the percentage of misuse was much smaller: 0.9 percent.
This number can vary depending on where they live: In some U.S. schools, as many as 1 in 4 high school students report misusing prescription stimulants, often motivated by their desire to perform better in school. Some schools report no issue with stimulant misuse.
What are the potential side effects?
Taking stimulants can cause elevated blood pressure and heart rate, a reduced appetite, difficulty sleeping, and restlessness or agitation.
Other common side effects include headaches, an increase in body temperature and abdominal pain.
Less frequently, stimulants have been known to temporarily slow a child’s growth, Dr. Rostain said, which is why they should have their height and weight monitored by a medical provider while they’re taking the drugs.
There is also a small risk of developing psychosis that may be tied to dosage. And when stimulants are misused, they can be addictive.
Patients and their doctors have to weigh the benefits of taking stimulants against these risks. A.D.H.D., particularly when left untreated, is associated with reckless behaviors like careless driving, unsafe sex, substance abuse and aggression. A recent study showed that people with the diagnosis are, on average, dying earlier than their peers — about seven years earlier for men, and about nine for women.
How long should stimulants be used?
It depends.
Studies have shown that A.D.H.D. symptoms can change over time, improving and then worsening again, or vice versa. “It’s not consistent,” Dr. Rostain said. “They wax and wane for many people.”
As a result, he added, people may end up using A.D.H.D. medications intermittently.
Still, some people take these drugs longer term, said Dr. Lenard A. Adler, the director of NYU Langone Health’s Adult A.D.H.D. Program.
“That being said, it’s always appropriate when someone is stable on psychostimulants to attempt to lower the dose,” Dr. Adler added.
If a patient continues to do well, he said, then it’s worth exploring whether the medication is still needed.
Is there still a medication shortage?
Yes.
The stimulant shortage that began in 2022 continues. According to the Food and Drug Administration, as of March, methylphenidate hydrochloride extended release tablets and patches, as well as other types of amphetamine tablets, are either unavailable or in short supply.
The availability of specific drugs and formulations can vary by region, Dr. Rostain said.
“It leads to a lot of uncertainty, unpredictability and a lot of anxiety on the part of patients,” he added.
Health
Brain Health Challenge: Try the MIND Diet
Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.
Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.
So what foods are best for your brain?
In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.
Based on these findings, the researchers developed the MIND diet.
Large studies encompassing thousands of people have since shown that following the MIND diet corresponds with better cognitive functioning, a lower risk of dementia and slower disease progression in people with Alzheimer’s. People benefit from the diet regardless of whether they start it in midlife or late life.
Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.
Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.
Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.
Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.
You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.
Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.
Health
Measles outbreak explodes in South Carolina; multiple people hospitalized as cases surpass 200
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The South Carolina Department of Public Health (DPH) is sounding the alarm after 26 new measles cases were reported since Friday, bringing the total number of cases in the state’s latest outbreak to 211.
DPH first reported a measles outbreak Oct. 2 in the Upstate region. As of Tuesday, 144 people are in quarantine and seven people are in isolation.
Of the 211 cases, 45 involve children under 5, 143 cases involve children ages 5 to 17, 17 cases involve adults and six cases involve minors whose ages weren’t disclosed.
DPH said 196 of the 211 infected individuals were unvaccinated, four were partially vaccinated, one was vaccinated and 10 are either still being investigated or have an unknown vaccination status.
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Hundreds of people in South Carolina have contracted the measles, and a few have been hospitalized. (Jan Sonnenmair/Getty Images)
Officials said 19 of the new cases were associated with “exposures in known households and previously reported school exposures,” and four resulted from church exposures.
DPH identified public exposures at Sugar Ridge Elementary and Boiling Springs Elementary and began notifying potentially exposed students, faculty and staff Dec. 31.
There are nine students in quarantine from the two schools.
Of the 211 cases, 45 involve children under 5 years old. (iStock)
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Exposures also happened at the Tabernacle of Salvation Church, Unitarian Universalist Church of Spartanburg, Slavic Pentecostal Church of Spartanburg and Ark of Salvation Church.
The source of one case is unknown, while two others are still being investigated.
Although complications from measles are not reportable, officials said four people, including adults and children, required hospitalization for complications from the disease.
Officials recommend all children be vaccinated against measles. (Raquel Natalicchio/Houston Chronicle via Getty Images)
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Additional cases required medical care, but the infected individuals were not hospitalized.
Those infected with measles are contagious from four days before the rash appears and may be unaware they can spread measles before they know they have the disease, according to DPH.
DPH said it is important for those with a mild illness or those who are in quarantine to stay home to protect others.
“We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine, which also protects businesses, other workers and clients,” officials wrote in a statement.
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DPH said vaccinations continue to be the best way to prevent measles and stop the outbreak.
Though the CDC recently released new vaccine recommendations under Health and Human Services Secretary Robert F. Kennedy Jr., its guidelines still dictate all children should be immunized for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and chickenpox.
Health
Common pain relievers may raise heart disease and stroke risk, doctors warn
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Many might assume that over-the-counter (OTC) medications are generally safer than stronger prescription drugs, but research shows they can still present risks for some.
Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks.
Potential risk of NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) — which are used to reduce pain, fever and inflammation — have been pinpointed as the class of medicines most linked to elevated cardiovascular risk.
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“This is because they reduce the production of certain chemicals called prostaglandins,” Maryam Jowza, M.D., an anesthesiologist at UNC Health in North Carolina, told Fox News Digital. “These chemicals are involved in inflammation, but they are also involved in other body functions, such as influencing the tone of blood vessels.”
Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks. (iStock)
Dr. Marc Siegel, Fox News senior medical analyst, echoed the potential risk of NSAIDs.
“They can lead to high blood pressure, heart attack and stroke via fluid retention and salt retention,” he told Fox News Digital. “This increases volume, puts a strain on the heart and raises blood pressure.”
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Common examples of NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, indomethacin and celecoxib.
Randomized trials found that ibuprofen caused the biggest spikes in blood pressure, followed by naproxen and then celecoxib.
“In general, the increase in blood pressure is more likely with higher doses and longer duration of treatment,” said Jowza, who is also an associate professor in the Department of Anesthesiology at the UNC School of Medicine.
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NSAIDs can also increase stroke risk, especially at high doses and with long-term use, the doctor added.
Diclofenac was linked to the highest cardiovascular risk, the doctor cautioned. Ibuprofen can also raise blood pressure and has been associated with a higher heart attack and stroke risk, but not as high as diclofenac. Naproxen carries a lower cardiovascular risk than ibuprofen or diclofenac, but is not entirely risk-free.
NSAIDs have been pinpointed as the class of medicines most linked to elevated cardiovascular risk. (iStock)
“The practical takeaway is that diclofenac is generally the least favorable choice in patients with elevated cardiovascular risk, and all NSAIDs should be used at the lowest effective dose for the shortest duration,” Dr. Nayan Patel, pharmacist and founder of Auro Wellness in Southern California, told Fox News Digital.
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Aspirin is an exception — although it is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. However, it can increase bleeding risk and blood pressure at high doses.
Non-NSAIDs safer, but not risk-free
Non-NSAID pain relievers are commonly used for everyday aches, headaches and fever, but not swelling. They act mainly on the brain’s pain signals, not inflammation, according to medical experts.
Acetaminophen, the most common non-NSAID pain reliever, is also linked to an increase in blood pressure, although to a lesser extent, according to Jowza.
“All NSAIDs should be used at the lowest effective dose for the shortest duration.”
“Acetaminophen was once thought to have little to no cardiovascular effects, but more recent evidence suggests it can increase blood pressure, especially with higher doses used in the long term,” she said, emphasizing the importance of blood pressure monitoring. “Its effect on stroke risk is less clear.”
Which groups are most vulnerable?
The groups at greatest risk, according to doctors, are those with existing health conditions, such as high blood pressure, prior stroke or heart disease, diabetes or kidney problems.
“These groups are also more likely to experience NSAID-related fluid retention and destabilization of blood pressure control,” Patel said.
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Cardiovascular risk is generally higher for people 75 and older, the doctors agreed.
“Age amplifies risk largely because baseline cardiovascular risk increases with age, and kidney function reserve tends to decline,” Patel said. “Older adults are also more likely to be on antihypertensives, diuretics, antiplatelets or anticoagulants, so NSAIDs can destabilize blood pressure control and add safety complexity.”
Warning signs
Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, Jowza advised.
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“These symptoms can point to a heart attack or stroke,” she warned. “Other symptoms of concern that may not develop as rapidly, like new swelling in the legs, should also prompt medical attention.”
Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, a doctor advised. (iStock)
“Patients should also seek medical advice if they notice signs of fluid retention or kidney stress, such as rapidly rising blood pressure, swelling in the legs, sudden weight gain over a few days, reduced urine output or worsening shortness of breath,” Patel added.
Safer alternatives
For those at higher risk, Patel recommends non-NSAID approaches whenever possible.
“For many patients, this means starting with non-drug strategies such as heat or ice, physical therapy and activity modification,” he told Fox News Digital. “If medication is needed, acetaminophen is generally preferred over oral NSAIDs from a cardiovascular standpoint, although regular use should still be monitored in people with hypertension.”
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For localized joint or muscle pain, the doctor said topical NSAIDs can offer “meaningful relief” with “far lower” risk.
“Overall, pain management in high-risk patients should emphasize targeted therapy, conservative dosing and close blood pressure monitoring.”
Bottom line
The doctors emphasized that the overall risk is “very low” for people taking OTC pain relievers on a short-term basis, but it rises with long-term, high-dose use.
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“I would not hesitate to use an occasional dose if it were a low-risk individual with no prior history of heart attack or stroke,” Jowza said. “I also think short-term use in diabetics and hypertensives who are well-controlled is acceptable.”
Although aspirin is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. (iStock)
For those taking NSAIDs, the doctor suggested using “guard rails” — such as regularly testing blood pressure and kidney function, and setting limits on dosing — to make treatment as safe as possible.
Patel agreed that for most healthy individuals, occasional NSAID use “does not carry a meaningful cardiovascular risk.”
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“The concern is primarily with repeated or chronic use, higher doses, and use in people with underlying cardiovascular, kidney or blood pressure conditions,” he confirmed to Fox News Digital.
“That said, large population studies show that cardiovascular events can occur early after starting NSAIDs, particularly at higher doses, which is why even short-term use should be approached cautiously in higher-risk patients.”
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