For many years now, both medical professionals and parents of children diagnosed with ADHD have assumed that the primary mechanism of action for most ADHD medications are its effects in the brain areas responsible for attention. Now a study suggests that the medications work in other parts of the brain, those involved with reward and wakefulness. This new information not only proves that science is rarely settled, but that we need to reexamine how we treat ADHD.
Researchers from Washington University used functional MRI’s (MRI’s that can measure brain activity in real-time) to determine which areas of the brain are changed by the administration of ADHD medications. Rather than stimulating attention areas of the brain, the medicines stimulation areas for alertness, wakefulness, and reward. When retested in healthy adults without ADHD, the same areas were stimulated. This suggests that the medications make the activities feel more rewarding.
While previous understanding of the mechanism was somewhat paradoxical, this understanding seems to make more sense. The children on these meds find previously uninteresting activities to be more rewarding, and thus they will engage in them.
While the study showed that many children performed better in testing, not all children saw benefits. For instance, benefits appeared in children who did not get the recommended 8-9 hours of nightly sleep. Apparently, sleep and ADHD symptoms were related; the medication seemed to be reversing the effects of insufficient sleep.
Helping our patients restore healthier, more abundant life requires that functional medicine providers like us not only understand natural but also conventional therapies. We look forward to more research like this.
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Original Article:
Benjamin P. Kay, Muriah D. Wheelock, Joshua S. Siegel, Ryan V. Raut, Roselyne J. Chauvin, Athanasia Metoki, Aishwarya Rajesh, Andrew Eck, Jim Pollaro, Anxu Wang, Vahdeta Suljic, Babatunde Adeyemo, Noah J. Baden, Kristen M. Scheidter, Julia S. Monk, Forrest I. Whiting, Nadeshka Ramirez-Perez, Samuel R. Krimmel, Russell T. Shinohara, Brenden Tervo-Clemmens, Robert J.M. Hermosillo, Steven M. Nelson, Timothy J. Hendrickson, Thomas Madison, Lucille A. Moore, Óscar Miranda-Domínguez, Anita Randolph, Eric Feczko, Jarod L. Roland, Ginger E. Nicol, Timothy O. Laumann, Scott Marek, Evan M. Gordon, Marcus E. Raichle, Deanna M. Barch, Damien A. Fair, Nico U.F. Dosenbach. Stimulant medications affect arousal and reward, not attention networks. Cell, 2025; 188 (26): 7529 DOI: 10.1016/j.cell.2025.11.039
Thanks to Science Daily:
Washington University in St. Louis. “ADHD drugs don’t work the way we thought.” ScienceDaily. ScienceDaily, 29 December 2025. <www.sciencedaily.com/releases/2025/12/251225235942.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
Colson Potter writes copious fiction and nonfiction, including a weekly Proverbs post and his blog at Creational Story.
