Bouts of hot flashes and trouble with memory and coordination encapsulate menopause symptoms for most women. While memory lapses can cause some women to believe they have early onset dementia, this is actually a side effect of low estrogen levels associated with menopause. However, an attention deficit hyperactivity disorder (ADHD) drug, lisdexamfetamine (LDX), may help treat cognitive and mood decline by improving working memory and recall in post-menopausal women, according to a recent study.
“It is crucial that we identify treatment options for those women who experience significant changes in cognition during this transition, whether it occurs naturally or is induced by surgery or chemotherapies,” said C. Neil Epperson, director of the Penn Center for Women’s Behavioral Wellness, according to the University of Pennsylvania (Penn) news release. Currently, estradiol treatment — a form of estrogen — is only able to treat a subset of the population of menopausal women with cognitive and mood complaints, and for other women, estradiol is not an option due to other medical conditions. Epperson and her colleagues believe LDX, the third-most popular ADHD medication, could provide the same benefits as estradiol by significantly reducing “brain fog.”
The team of researchers at the Perelman School of Medicine at Penn evaluated the effects of LDX on a cohort of women in their early post-menopausal years. They recruited a total of 30 women between the ages of 48 and 60, who had a diminished ability to focus and multi-task during this time and were more than five years post-menopause. The participants participated in the study for a total of eight weeks.
During the first four weeks, the participants followed a LDX regimen, and then they followed a placebo in the last four weeks to accurately assess the drug’s effectiveness in reducing executive function difficulties and improving performance on verbal recall, working memory, and attention tasks. Some of the participants underwent brain imaging, functional MRI, and proton magnetic resonance spectroscopy to examine brain activation, along with dorsal lateral prefrontal cortex neurochemistry.
“The women were then asked to report their level of executive function across these five domains: organization and motivation for work; concentration and attention; alertness, effort and processing speed and managing affective interference, the tendency to overly focus on the emotion of a message; and working memory and recall,” according to Medical Xpress.
The findings revealed the women who received the LDX treatment reported a significant reduction in the severity of all menopausal symptoms, except the over-attention to emotion, which wasn’t initially a major complaint among the women. Moreover, the participants in the study who experienced the most severe symptoms were also shown to have the most striking improvement, while others showed no improvement at all.
"While some individuals experienced no improvement with LDX, we were heartened by these findings and hope to examine the genetic profile of our participants in the near future to determine whether there are predictors regarding who is most likely to experience improvement with this kind of treatment," Epperson said in the news release.
Epperson was drawn to this type of research after a handful of women were coming to her practice with concerns about the early onset of dementia. She told the Daily Beast their problems with memory, concentration, and ability to focus at work were the side effects of low estrogen levels linked to menopause. Although menopausal women are treated with hormones, they often aren’t effective for all women and aren’t even an option for those with certain medical conditions. Epperson believes this is where stimulants such as LDX may be able to remedy these memory lapses.
While Epperson’s study has reported success, we should be cautious when interpreting the results. “This is with only four weeks of treatment. We don’t know what would happen if they took this for a longer period of time,” she said. The findings were heavily reliant on self-reporting and could lead to a better self-assessment of their capabilities, since the drug is intended to make people feel better.
The ADHD drug was suitable for the menopausal women in the study, but does not suggest it would be for all menopausal women in general. Stimulants would also not be suitable treatment for women with hypertension or a history of addiction.
In the United States, 51 is the average age that women reach menopause, with 85 percent of American women experiencing various levels of hot flashes and others experiencing memory lapses in their forties and fifties, according to the National Institute of Aging.
Source: Epperson et al. Mid-life Onset of ADHD-like Cognitive Impairments in Menopausal Women. Abstract. 2014.