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How Ritalin Affects Brains of Kids With ADHD

Medication activates areas associated with the disorder, scans show


In three out of five of the inhibitory control studies, Ritalin at least partially normalized brain activation in ADHD children.

To note how the brain reacted to a selective attention test, Moore said, children would first be asked, for example, what word they were seeing. The word would be "red," and the color of the type also would be red. Then they would be shown the word "red," but the color of the type would be green. In several studies, Ritalin affected activation in the frontal lobes during such inhibitory control tasks.

Most of the studies included in the review were performed in the United States or the United Kingdom. The majority of participants were adolescent boys, and all studies compared their results to healthy children of the same approximate age.

Because none of the studies looked at the correlation between ADHD symptoms and whether the child was taking Ritalin, there is no way to link the changes in brain activation with clinical improvement, Moore said. "It's possible that kids who are not responsive to Ritalin may have brain changes too," she said.

ADHD affects between 3 percent and 7 percent of school-aged children in the United States, according to the American Psychiatric Association. Boys are more likely to have ADHD than girls.

One expert was not surprised by the results.

"The review article shows there is a consensus of well-designed imaging studies showing that [Ritalin] has an impact on the frontal cortex of the brain, where we have long believed these patients have issues," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center of New York, in New Hyde Park. Adesman wondered if Ritalin may play a role in helping the brain mature.

"Their data provides partial support for that," he said. "But if anything, the medicine seems to help the brain look more normal and doesn't seem to do anything bad to it."

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