ADHD, Medication and Exercise

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Dr. John Ratey, MD, is probably the foremost expert on ADHD today. He was recently interviewed by Medscape Psychiatry and the following posting is a discussion of his points of view and findings. Dr. Ratey is the author of many books on the topic and is an Associate Clinical Professor of Psychiatry at Harvard Medical School. Probably the most well know popular book he wrote is Driven to Distraction. His most recent book is Spark: The Revolutionary New Science of Exercise and the Brain.

According to Dr. Ratey, exercise can reduce and possibly eliminate the need for medication in many children with ADHD. Here is my summary of his explanation of why exercise might replace medication for ADHD:


The brain is made up of approximately a hundred billion brain cells called neurons. These neurons transmit messages from the peripheral parts of the body to the brain and back again. In order to make this system of communication work there are bio chemicals called neurotransmitters.

Two of the neurotransmitters are norepinephrine and dopamine. Both of these impact on the ability to focus attention. When levels of dopamine and norepinephrine are too low people experience difficulty concentrating on what they need to do. Consequently, "executive functions" suffer. Executive functions refers to such things as self-control, planning, reasoning, and abstract thought.
Presently, stimulant medications, such as Ritalin, are used to correct for this disorder. These medications  increase the supply of neurotransmitters resulting in improved ability to focus attention and function at school and work. However, as with all medications, there are unwanted side effects. According to Dr. Ratey, this is where exercise plays an important role.

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It is Dr. Ratey's contention that exercise has similar results as the use of medication but without the side effects. In other words, children and adults with ADHD can improve their executive functioning and even permanently correct for ADHD. He goes on to report that all the neurotransmitters in the brain increase their supply levels, bringing about improved brain function in many areas of life.

This is why Dr. Ratey and other psychiatrists strongly recommend for exercise for everyone whether they have a disorder or not. The reasons given are that exercise sharpens the brain and the ability to think. In addition, moods improve with exercise and the impact of stress is reduced. It is not known for sure, but, exercise may postpone or prevent the onset of Alzheimer's Disease. In addition, it improve overall memory, learning and intellectual functions.

With regard to ADHD, Dr. Ratey plainly states that activities such as running, biking and other aerobic exercises, keep the symptoms under control.

If you are an adult, with or without ADHD and are considering starting an exercise program, see your MD and get medical clearance. People with heart conditions or other physical issues should always follow the recommendations of their physicians before doing any strenuous activities.

Your comments and questions are welcome.

Allan N. Schwartz, PhD 

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