Recent studies suggest a possible neuroprotective effect of stimulants on ADHD brain development.

Over a lifespan, the brains of individuals with ADHD often experience delayed cortical maturation in childhood, especially in areas related to attention and self-regulation. This is followed by a pattern of slower or altered brain volume growth into adolescence and adulthood. Unlike neurotypical development, which usually follows a more consistent trajectory of brain maturation and pruning, ADHD brains may exhibit reduced overall volume starting in childhood. In adulthood, ADHD brains may experience more volume loss as they age compared to those without the condition.

However, over the past 10 years, several studies have suggested that treatment with stimulant medications may help protect the brain, as those treated with stimulants show less reduction in brain volume, potentially preserving brain structure and function throughout adulthood. Here are a couple of examples:

• A recent study published in Neuropsychopharmacology in December 2024 investigated the impact of stimulant medications on brain structures in children with ADHD. Researchers analyzed MRI data from over 7,000 children ages 9 to 10 and found those with ADHD symptoms who were not on medication exhibited structural abnormalities in brain regions associated with attention and reward processing. In contrast, children with ADHD symptoms who were treated with stimulant medications did not show these abnormalities, suggesting such treatments may help normalize certain brain structures particularly affected by ADHD.

• A 2013 meta-analytic review published in the Journal of Clinical Psychiatry examined how stimulant medications affect structure and function of brains with ADHD. Researchers analyzed 29 MRI-based studies, including structural and functional imaging, to compare medicated and unmedicated individuals with ADHD. The findings suggest that therapeutic doses of stimulants may reduce brain abnormalities typically seen in unmedicated ADHD patients, bringing their brain activity and structure closer to that of individuals without ADHD. These brain changes are believed to contribute to the clinical improvements observed with stimulant treatments.

Overall, the evidence indicates that stimulant medications can positively influence brain function and structure in those with ADHD.

While stimulant medications play a crucial role in managing ADHD symptoms and supporting brain development, medications alone may not address the full range of challenges faced by individuals with ADHD. Combining medication treatment with executive function skills training—such as coaching or therapy—can help individuals develop essential life skills like organization, time management, and emotional regulation. Medication may improve brain structure and function, but coaching and therapy provide practical strategies to improve day-to-day functioning and help individuals with ADHD better manage tasks, relationships, and their overall well-being. This comprehensive approach ensures both the neurological and behavioral aspects of ADHD are addressed, leading to more sustainable and effective outcomes in both childhood and adulthood.

Empowering individuals with ADHD starts with providing a clear evaluation to correctly identify a diagnosis and treatment plan. By combining medication with skills building through executive function coaching or therapy, we can help people with ADHD unlock their full potential, navigate challenges with confidence, and embrace their unique strengths. With the right resources and strategies, individuals with ADHD can find success on their own terms, making meaningful contributions to the world around them.