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01/27/2026 | News release | Distributed by Public on 01/27/2026 12:24

ADHD medications stimulate alertness, motivation

January 27, 2026

ADHD medications stimulate alertness, motivation

At a Glance

  • Researchers found that prescription stimulants for ADHD act on brain networks that control wakefulness and reward, but not attention as previously thought.
  • The study suggests that stimulants and additional sleep affect the brain in similar ways, and that getting enough sleep could help in managing ADHD.

Attention-deficit/hyperactivity disorder, or ADHD, can affect a person's ability to focus on certain tasks, resist impulses, and refrain from moving around. Stimulant medications containing methylphenidate (Ritalin) or amphetamine (Adderall) are often prescribed to treat ADHD.

Stimulants were long thought to act on parts of the brain that promote a person's ability to pay attention. But new imaging techniques can let scientists take a more detailed look at how stimulants affect the brain. A research team led by Drs. Benjamin Kay and Nico Dosenbach of Washington University School of Medicine in St. Louis focused on the specific brain networks that ADHD stimulants act upon. Results appeared in Cell on December 24, 2025.

The scientists analyzed data collected between 2016 and 2019 from NIH's ongoing Adolescent Brain Cognitive Development (ABCD) study, a large U.S. study of brain development and child health. The team focused on data from nearly 5,800 children, ages 8 to 11, who completed functional MRI brain scans, which measure brain activity by detecting blood flow when at rest. Of these, 337 children (73% of whom were boys) took a stimulant medication the morning of their scans. About 76% of the kids who took a stimulant on the morning of their scan met criteria for ADHD.

The researchers looked for stimulant-related changes in synchronized activity within and between brain neuron networks. They observed specific differences between the scans of those who took a stimulant and those who did not.

Stimulants affected activity in brain networks that control how alert or awake a person feels. The team also observed changes in reward-based networks linked to drive and motivation. However, the networks that control attention remained unchanged. In a controlled experiment to confirm these results, detailed MRI scans were done in five healthy adults while on and off a stimulant. The stimulants acted on the same wakefulness and reward regions in adults.

The team found that the effects of stimulants resembled changes associated with getting more sleep, which is often impaired in children with ADHD whether or not they take stimulants. Among children with ADHD, stimulants were linked to improved school grades and cognitive test scores. Taking a stimulant improved performance in children who had insufficient sleep. However, stimulants did not improve the performance of children without ADHD who got adequate sleep.

"Essentially, we found that stimulants pre-reward our brains and allow us to keep working at things that wouldn't normally hold our interest-like our least favorite class in school, for example," Dosenbach explains. "These results also provide a potential explanation for how stimulants treat hyperactivity, which previously seemed paradoxical. Whatever kids can't focus on-those tasks that make them fidgety-are tasks that they find unrewarding. On a stimulant, they can sit still better because they're not getting up to find something better to do."

The findings suggest that, in addition to considering stimulants, clinicians should address inadequate sleep in children being evaluated for ADHD. While stimulants can impair sleep for some children with ADHD, they can improve sleep for those with pre-existing sleep problems. Additional studies are needed to better understand and predict how stimulants affect sleep in individual patients.

-by Caroline Stetler

Related Links

References

Stimulant medications affect arousal and reward, not attention networks. Kay BP, Wheelock MD, Siegel JS, Raut RV, Chauvin RJ, Metoki A, Rajesh A, Eck A, Pollaro J, Wang A, Suljic V, Adeyemo B, Baden NJ, Scheidter KM, Monk JS, Whiting FI, Ramirez-Perez N, Krimmel SR, Shinohara RT, Tervo-Clemmens B, Hermosillo RJM, Nelson SM, Hendrickson TJ, Madison T, Moore LA, Miranda-Domínguez Ó, Randolph A, Feczko E, Roland JL, Nicol GE, Laumann TO, Marek S, Gordon EM, Raichle ME, Barch DM, Fair DA, Dosenbach NUF. Cell. 2025 Dec 24;188(26):7529-7546.e20. doi: 10.1016/j.cell.2025.11.039. PMID: 41448140.

Funding

NIH's National Institute of Mental Health (NIMH), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Drug Abuse (NIDA); National Spasmodic Dysphonia Association; Mallinckrodt Institute of Radiology; McDonnell Center for Systems Neuroscience; Behavior Research Foundation; Taylor Family Institute Fund for Innovative Psychiatric Research; and the Extreme Science and Engineering Discovery Environment Bridges at the Pittsburgh Supercomputing Center. 

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