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Are SSRIs Effective for Treating ADHD?

ByPrimary Researcher

Executive Summary

  • One of the common off-label prescriptions for SSRIs is ADHD.
  • We evaluate the evidence for the effectiveness of an SSRI for ADHD.

Introduction

Ever since SSRIs were first introduced, they began expanding in their off-label applications. A major off-label prescription has become for treating ADHD. This article investigates whether SSRI antidepressants are effective for ADHD as the medical establishment has claimed.

tudies into Prozac for ADHD

This results from a study reported in the NIH’s publication site PubMed for Prozac that states it is effective. Fluoxetine is the drug sold under the Eli Lilly Brand of Prozac.

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) share brain function abnormalities during cognitive flexibility. Serotonin is involved in both disorders, and selective serotonin reuptake inhibitors (SSRIs) can modulate cognitive flexibility and improve behavior in both disorders.

That is not true. The low serotonin hypothesis for depression has been disproven as I cover in the article How the Establishment Media Promotes Taking SSRIs While Admitting the Low Serotonin Hypothesis is False. The evidence for serotonin being related to ADHD and autism is not stronger than the evidence presented for its connection to depression. Eli Lilly is the pharmaceutical company that promoted this evidence-free claim. The quote continues.

In ADHD children, Fluoxetine monotherapy has been shown to significantly improve inattentiveness and hyperactivity in noncomorbid groups (Barrickman et al. 1991), as well as in groups with co-morbid bipolar disorder (Quintana et al. 2007). Fluoxetine also appears to moderate the efficacy of stimulant medication, as evidenced by the finding that combined Fluoxetine–Methylphenidate treatment reduces ADHD symptoms in co-morbid ADHD children (Gammon and Brown 1993; Findling 1996). To summarize, we found disorder-specific underactivation in ASD boys in mPFC, a key region of reversal learning, as well as disorder-dissociated inverse effects of Fluoxetine on this region, which upregulated and normalized dysfunction in ASD but down-regulated activation in ADHD, concomitant with worsening their task performance. The findings may indicate dissociated underlying 5-HT abnormalities in the 2 disorders.

This is a curious study conclusion. But it is explained by the following statement regarding the researchers’ conflicts of interest.

Conflict of Interest: K.R. has received funding from Lilly for another project and speaker’s honoraria from Lilly, Shire, Novartis, and Medice. M.B. is consultant for P1 Vital, Oxford, UK. The other authors have no conflict of interests to declare.

Eli Lilly or “Lilly” is the maker of Prozac. Hence is it surprising that this study showed Prozac worked for ADHD? The other funders are also interesting.

This work was supported by the UK Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London. Funding to pay the Open Access publication charges for this article was provided by the Biomedical Research Centre.

However, how many of these entities also have financial support and conflicts from Eli Lilly? It is safe to assume that all of them do.

Common Antidepressants Prescribed for ADHD

According to WebMD, SSRIs tend to be prescribed when amphetamines like Ritalin or Adderall are found to be ineffective. This is explained in the following quotation.

A lot of adults with ADHD (attention deficit hyperactivity disorder) take stimulant drugs to manage their symptoms. But if you don’t get better with those medicines, or you don’t like how they make you feel, your doctor may suggest you try an antidepressant.

Sometimes the MDs prescribe SSRI for ADHD because the patient has a variety of symptoms. There is also an overlap between ADHD and depression. Both are marked by problems in concentration and overall attention spans. Some adults with ADHD also have depression and anxiety. Antidepressant drugs might be an option if that’s your situation since they can treat these conditions as well as ADHD.

When it comes to improving your concentration or attention span, SSRI usually don’t work as well as stimulants and other drugs made specifically to treat ADHD.

While part of this statement is correct — the part about having SSRI for ADHD not working as well as stimulants to treat this condition — the problematic part of this statement is that studies have not even found a relationship between these neurotransmitters and depression. WebMD leaves out this information — because pharmaceutical companies fund WebMD to keep saying this to readers long after this hypothesis has been proven to be false. GoodRx addresses this same topic in the following quotation.

Both ADHD and depression are linked to low levels of the neurotransmitter dopamine in the brain, which is involved in pleasure, concentration, motivation, and movement. Many of the medications used to treat depression and ADHD aim to increase dopamine levels.