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
Frequent heartburn may be a warning sign of a more dangerous condition, doctor says
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For most people, heartburn is an occasional annoyance and source of temporary discomfort. But for some, chronic heartburn can lead to more dangerous conditions — potentially even pre-cancerous ones.
About 10% of people with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer, according to medical experts.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer, but most will not.
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When acid reflux becomes dangerous
“Your stomach is designed to handle acid. Your esophagus is not,” Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist, told Fox News Digital.
About 10% of people with chronic acid reflux will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer. (iStock)
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
In most people, the lower esophageal sphincter — which Gioffre refers to as the “acid gate” — keeps acid in the stomach, which is lined with thick mucus and specialized cells designed to protect it.
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” he said. This “gate” can weaken with magnesium deficiency, high stress, alcohol, poor sleep, dehydration and late-night snacking, all of which can disrupt healthy digestion.
When acid hits the esophagus, it irritates tissue that was never designed to withstand it, according to the doctor.
“Every time acid comes back up the wrong way, it injures the lining like a slow chemical burn,” said Gioffre, who is also the author of “Get Off Your Acid” and “Get Off Your Sugar.” Over time, that irritation erodes the lining, drives inflammation and can change the cells.
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“These new cells are no longer normal esophageal cells — they begin to shift into cells that look more like stomach lining, because those cells can tolerate the acid,” the doctor said. “That change is called metaplasia, or Barrett’s esophagus.”
Once the cells start changing, the risk of further mutation goes up. If that process continues, Gioffre warned, it can progress to dysplasia, which is the stage right before esophageal cancer.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer. (iStock)
“So the real danger is not the heartburn you feel,” he summarized. “It is the repeated acid exposure forcing the esophagus to adapt in ways it was never designed to. Fixing reflux at the root stops this entire cascade before those cellular changes begin.”
Men at higher risk
Men generally have a higher risk because they burn through magnesium faster, tend to carry more visceral fat pushing upward on the stomach, eat heavier meals and snack late at night, Gioffre cautioned. These activities all weaken the acid gate and shut down healthy digestion.
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“Eating within three hours of lying down almost guarantees the stomach does not empty, and that is one of the biggest drivers of nighttime reflux,” he said. “On top of that, men often ignore symptoms, or mask them with PPIs and antacids instead of fixing the root cause.”
All of these factors contribute to a “perfect storm” for chronic inflammation and long-term damage, according to Gioffre.
Warning signs
There are certain red flags that indicate when acid reflux has gone beyond an occasional annoyance and has progressed to constant and chronic.
“If that burn becomes more frequent or more intense, or starts showing up even when you have not eaten, your body is waving a giant warning flag,” Gioffre said.
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach. (iStock)
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach, according to the doctor.
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“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” he warned.
“Another major warning sign is when reflux goes from something you notice occasionally to something you feel every day or every night, or when PPIs and antacids stop helping,” Gioffre said. “That usually means the lining is irritated and eroded, and may already be changing on a cellular level.”
Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, the doctor said. (iStock)
Unexplained weight loss, vomiting blood and black stools are all serious symptoms that demand immediate attention, the doctor added.
“The bottom line: When reflux becomes consistent, chronic and starts impacting swallowing, your voice, or the tissues in your mouth or throat, it is no longer just a nuisance,” Gioffre told Fox News Digital. “That is the point where the esophagus may be moving toward a precancerous state, and men especially cannot afford to wait on it.”
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3 key ways to prevent reflux
Gioffre shared the following essential steps to preventing acid reflux and improving digestive health.
No. 1: Follow the 3-hour rule
“Stop eating three hours before bed,” the doctor recommends. “When you eat late, the stomach does not empty, pressure builds and the acid gate relaxes, guaranteeing that acid travels upward into your esophagus while you sleep.”
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Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, he warned. “This one rule alone can dramatically lower acid reflux and cancer risk.”
No. 2: Strengthen the acid gate
When stomach acid is low, the lower esophageal sphincter loses its tone, allowing acid to travel upward instead of staying in the stomach, Gioffre said.
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“The fastest way to tighten that gate is to build your mineral reserves, especially magnesium,” he said.
The best way to do this is to load up on magnesium-rich foods like avocado, spinach, pumpkin seeds, chia seeds, quinoa and almonds, and consider adding a clean magnesium supplement.
No. 3: Remove or neutralize daily triggers
The fastest way to protect your esophagus, according to Gioffre, is to eliminate or neutralize the foods and habits that weaken the acid gate and push acid the wrong way.
For people who can’t fully eliminate these triggers, certain habits can help neutralize their impact by reducing acid strength and pressure before it reaches the esophagus.
The doctor recommends cutting back on alcohol and caffeine, both of which relax the acid gate and increase the risk of acid reflux. (iStock)
“Drinking most of your water earlier in the day helps, because pounding water at night stretches the stomach and relaxes the acid gate, making it much easier for acid to flow the wrong way once you lie down,” he said.
He also recommends cutting back on alcohol and caffeine, both of which relax the acid gate instantly.
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Some other major triggers that fuel the reflux cycle include chocolate, spicy foods, garlic, onions, sugar, ultraprocessed foods and heavy nighttime meals, according to the doctor.
“These foods and habits weaken the lower esophageal sphincter, drive up inflammation and push pressure upward,” he said. “That’s exactly how a little heartburn turns into chronic reflux, and slowly causes the kind of damage that puts the esophagus at risk for cancer.”
Health
Dairy consumption linked to lower dementia risk in surprising new study
RFK Jr. touts whole milk as healthier than alternatives
Fox News medical contributor Dr. Nicole Saphier joins ‘Fox & Friends Weekend’ reacting to HHS Secretary Robert F. Kennedy Jr.’s promotion of high-fat, high-protein foods and warning that replacing fat with sugar has fueled America’s obesity crisis.
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A large Swedish study suggests that some high-fat dairy foods are linked to a lower risk of dementia.
Researchers in Sweden used data from the Malmö Diet and Cancer cohort, which included 27,670 adults aged 45 to 73 in Malmö, Sweden.
The team then conducted interviews, collected food diaries, and asked the patients questionnaires to calculate how much of each dairy product people ate per day. They also separated dairy into high-fat and low-fat types. High-fat cheese was defined as more than 20% fat, and high-fat cream as more than 30% fat.
Participants joined the study between 1991 and 1996 and were followed for an average of 25 years afterward.
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People who consumed at least 20 grams per day of high-fat cream had about a 16% lower risk of all-cause dementia than non-consumers. (iStock)
The main outcome they looked at was all-cause dementia, while Alzheimer’s disease (AD) and vascular dementia (VaD) were studied separately. Over the follow-up period, 3,208 people developed dementia. Within these groups, those who consumed high-fat cheese were significantly less likely to develop dementia.
“We were a bit surprised to see a lower dementia risk among people who ate more high-fat cheese,” Emily Sonestedt, associate professor of nutritional epidemiology at Lund University in Sweden, told Fox News Digital.
At the same time, she says it isn’t entirely unexpected to see a link with vascular dementia.
Most other dairy products, including low-fat cheese, low-fat cream, milk and fermented milk, showed no consistent association with overall dementia risk. (iStock)
“Many dementia cases involve damage to small blood vessels in the brain. Our own previous work, and several international studies, including from the US, have shown neutral or slightly protective associations between cheese and cardiovascular disease.”
The study adjusted for factors such as age, sex, education, smoking, physical activity, alcohol use, body mass index, hypertension, overall diet quality and other dairy products.
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People who ate at least 50 grams per day of high-fat cheese had a lower risk of all-cause dementia compared with those eating less than 15 grams per day. They also had a lower risk of vascular dementia.
High butter intake was associated with a higher risk of Alzheimer’s disease, while high-fat cheese was linked to lower Alzheimer’s risk only among people without the APOE ε4 genetic risk variant. (iStock)
High-fat cream showed a similar pattern: people consuming at least 20 grams per day had a 16% lower risk for all-cause dementia compared with non-consumers.
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Other dairy products did not show clear links with overall dementia risk. Low-fat cheese, low-fat cream, milk, fermented milk, and butter generally showed no association with all-cause dementia.
One exception was that high butter intake (at least 40 grams a day) was associated with a higher risk of Alzheimer’s disease. The study also found that high-fat cheese was linked to lower AD risk only among people who did not carry the APOE ε4 risk variant, a genetic variant linked to Alzheimer’s.
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This was an observational study, so it cannot show cause and effect, and unmeasured factors may still play a role.
“The study was conducted in Sweden, where people mainly eat hard, fermented cheeses, so the results may not apply directly to countries with very different cheese types and eating patterns,” said Sonestedt.
Because the study was observational and diet was measured only once, the results should be interpreted cautiously and cannot be used to conclude that high-fat dairy prevents dementia. (iStock)
Diet was measured only once, so changes over time were not fully captured. Cream intake was measured with less precision than cheese.
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“Although we adjusted for many lifestyle and health factors, it is still difficult to say that the cheese itself is protective. It is more likely part of a broader eating pattern and lifestyle that may support long-term brain health,” researchers noted.
Dementia diagnoses after 2014 were not validated in detail, and baseline cognitive status was not available.
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Some dementia cases may have been missed, and the results are from a Swedish population, which may limit generalization.
The findings were published in Neurology, the medical journal of the American Academy of Neurology.
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Health
Misunderstood illness leaves millions exhausted, with most cases undiagnosed
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Fatigue can stem from a variety of illnesses and life stressors, but when that exhaustion lasts for months — often following an infection — it may indicate a condition called chronic fatigue syndrome.
Approximately 3.3 million people in the United States currently have the syndrome, with about one in four people confined to their bed at some point during the illness, according to the Centers for Disease Control and Prevention.
Despite its prevalence, experts say it’s a poorly understood condition that physicians frequently miss, with past research suggesting that only about 15% of those affected are diagnosed correctly.
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What is chronic fatigue syndrome?
Formally known as myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) is a chronic disease that causes fatigue so severe that it impairs the ability to perform daily activities.
Approximately 3.3 million people in the United States currently have the chronic fatigue syndrome, with about one in four people confined to their bed at some point during the illness. (iStock)
The National Academy of Medicine defines the syndrome as having the following three symptoms that last at least six months.
- Severe fatigue that is 1) new and 2) decreases the ability to perform activities that you did normally prior to illness
- “Malaise” that worsens after physical or mental effort that previously was well-tolerated
- Unrestful sleep
People may also experience trouble with thinking and memory (often called “brain fog”) or lightheadedness when standing up.
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There are no tests to confirm chronic fatigue, so doctors diagnose it by talking to their patients, examining them and excluding other disorders, like hypothyroidism and depression, that often share the same symptoms.
Chronic fatigue is frequently missed by physicians, with past research suggesting that only about 15% of those affected are diagnosed correctly. (iStock)
“CFS, fibromyalgia and long COVID are all related conditions with different names,” Dr. Jacob Teitelbaum, author of “From Fatigued to Fantastic” — whose research focuses on chronic fatigue syndrome — told Fox News Digital. “What these illnesses have in common is that they are immune disorders, and immune disorders predominantly affect women.”
Many genes related to immune disorders are on the X chromosome, suggesting a genetic component, the doctor added.
Causes of chronic fatigue
Chronic fatigue syndrome may be triggered by infection or other physiologic stressors, but its causes and symptoms can vary widely from person to person, according to Dr. Julia Oh, a professor in dermatology, molecular genetics and microbiology, and integrative immunobiology at the Duke University School of Medicine in North Carolina.
Teitelbaum compared the condition to a “severe energy crisis” in the body. When energy drops low enough, the “control center” in the brain — the hypothalamus, which regulates sleep, hormones, blood pressure and pulse — may not work as well.
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Although hypothalamic dysfunction can trigger dozens of other symptoms, the hallmark signs are insomnia (despite exhaustion), brain fog and widespread pain, the doctor said.
Anything that causes severe energy depletion can trigger the syndrome, including chronic life stressors, nutritional deficiencies, thyroid and stress hormone imbalances, and sleep problems.
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These triggers are usually associated with a gradual onset of CFS, but sudden onset can be caused by certain infections, with two classic ones being COVID and mononucleosis, past research has shown.
Head and neck trauma and sudden hormonal shifts after pregnancy can also trigger chronic fatigue, Teitelbaum warned.
Anything that causes severe energy depletion can trigger the syndrome, including chronic life stressors, nutritional deficiencies, thyroid and stress hormone imbalances, and sleep problems, according to one doctor. (iStock)
There aren’t currently any blood tests to uniformly diagnose the syndrome, but Dr. Oh said she is hopeful that will change in the future.
Her research team developed an experimental artificial intelligence-based tool, BioMapAI, that has been shown to identify the condition with high accuracy by analyzing stool, blood and other common lab tests, according to early research published in July in the journal Nature Medicine.
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“Instead of finding one smoking gun for the disease, our AI model uncovered a distinct biological fingerprint that was dysregulated in the patients, which spanned changes in gut bacteria, hyperactive immune cells and disrupted metabolism,” Oh told Fox News Digital.
Treatments and therapies
Given how differently chronic fatigue syndrome can affect people, there is no universally effective therapy, according to Oh.
The CDC recommends that patients with CFS work with their doctors to create a management plan based on the symptoms that most affect quality of life.
There are no tests to confirm chronic fatigue, so doctors diagnose it by evaluating symptoms and excluding other disorders.
Treatments generally include a combination of lifestyle changes, therapies and medications. Patients and their physicians should weigh the potential benefits and risks of any approach.
There are some alternative therapies that have shown to be effective for some. Teitelbaum developed a protocol called SHINE, which focuses on sleep, hormones and hypotension, infections, nutrition and exercise. Some research has shown that this approach can help to improve the quality of life for people with CFS and fibromyalgia.
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Others may find alternative treatments, like physiotherapy (physical therapy) to be helpful.
Those who experience persistent fatigue that hinders their ability to participate in regular activities or impacts their quality of life should speak with a doctor.
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