Hilmar Sigurðsson – ADHD and Medication – What About Exercise?

There is a growing concern among professionals in regards to increased use of ADHD prescription drugs. In this case I will not discuss the recreational use of such stimulants, rather discuss the increase rate of prescription for children and adolescents diagnosed with Attention-deficit hyperactivity disorder (ADHD).

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ADHD is a neurodevelopmental disorder, characterized by deficits in attention, hyperactivity and/or impulsiveness that is not age appropriate. In May 2011 a journal article was published in Acta Psychiatrica Scandinavica entitled: The use of ADHD drugs in the Nordic countries: a population-based comparison study. In this specific article the authors demonstrated that Iceland (my home country) had five-fold higher prevalence rate of medication prescription for ADHD per 1000 inhabitants compared to Sweden, for example. These results were consistent with recent news reports from Iceland, notifying the public of a substantial increase in medication prescription for children diagnosed with the disorder. For such a small nation, the rate of prescription is too high. Another similar study from Iceland demonstrated that approximately 8% of children between the ages of 9-12 were treated with ADHD medication. To put into perspective, a class of 25 students would include at least 2 who are prescribed ADHD medication. The stimulant treatment is also detrimental to their academic performance, in comparison with their peers. Interestingly, BBC news reported in August 2013 a similar situation in the UK. According to the Care Quality Commission between 2011 and 2012 an 11% rise had been observed in the prescription of ADHD medication. This rise is considered too steep and should be reviewed carefully by physicians. Thus, the question must be, aren’t there any other remedies?

The NHS lists, on its website, other possible forms of treatment to control ADHD symptoms. These remedies include psychoeducation, cognitive behavioural therapy and a change in diet. With all of these alternatives being more favourable than medication, the website does not recommend exercise as a possible therapy. A myriad of evidence suggests that exercise is quite powerful in controlling ADHD symptoms. Several scientists propose that physical exercise could be an effective treatment for the paediatric ADHD population. In particular, two recent studies showed that a moderate-to-vigorous exercise programs resulted in improvements in motor performance, social and behavioural functioning, information processing and response inhibition (Smith, et al. 2011; Verret, et al. 2012).

Moreover, the studies reported improvement in behaviours of interruption and rununintentional aggression, results that can be traced back to improvement in response inhibition. Physical exercise has also been shown to reduce stress, negative affect, anxiety and depression, as well as self-destructive behaviour (Archer and Kostrzewa, 2012). Despite few study limitations such as small sample sizes and short study duration, these results should be of interest since most participants had been treated with high doses of stimulants from a young age. Similar results have also been reported in other neurodevelopmental disorders where a high aerobic exercise resulted in a significant decrease in reaction times on cognitive tasks.

Lastly, looking at the most decorated Olympian of all time the effect of exercise minimizing symptoms of ADHD can be seen. Michael Phelps was diagnosed with ADHD at the age of 9. According to his mother, Michael suffered from a lack of concentration that affected his performance in school severely. Being physically active helped Michael to overcome his symptoms and quit taking medication.

Despite further research needed on the effect of exercise, it would be interesting to see exercise being recommended by physicians as a form of treatment of children and adolescents with ADHD.

Hilmar Sigurðsson (lpxhps@nottingham.ac.uk)
PhD Student, School of Psychology

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References

Archer,
T.
 & Kostrzewa, 
R.
M.
(2012).
Physical
 exercise
 alleviates
 ADHD 
symptoms:
 Regional
 deficits
 and
 developmental 
trajectory.
 Neurotoxicity 
research,
 21, 
195‐ 209.

Smith, A. L., Hoza, B., Linnea, K., Mcquade, J. D., Tomb, M., Vaughn, A. J., et al. (2011). Pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of attention disorders, 1-13.

Verret, C., Guay, M-C., Berthiaume, C., Gardiner, P., & Beliveau, L. (2012). A physical activity program improves behavior and cognitive functions in children with ADHD: An exploratory study. Journal of attention disorders, 16, 71-80.

 

 

 

 

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