Attention Deficit
Hyperactivity Disorder
Studies indicate that both children and adults can suffer from ADHD. And while the cause of ADHD is still unknown, researchers believe genetics, diet, environmental factors, and even infections and an abnormal immune system play a role.

When your ADHD medication is not working anymore

Is your ADHD medication not working anymore or have your medications made your symptoms worse? If so, you are not alone. Standard medications can be very effective in treating ADHD symptoms but for a significant number of patients, medications are not helpful. In fact, as many as 30% of children with ADHD do not respond to stimulants or cannot tolerate the side effects. 1

And 1 in 3 adults with ADHD do not improve on standard medications. 1

ADHD can greatly impair a person’s relationships, career, and day-to-day functioning. Individuals with ADHD have difficulty concentrating and focusing. They may exhibit impulsive behaviors, forgetfulness, aggression, irritability, impatience and have a low frustration tolerance. Typically, these symptoms are managed with standard medications and/or therapy.

If your ADHD medication is not working anymore, it could be due to several reasons: the dosage may be incorrect; adherence may be an issue; co-existing disorders may impede the medications effectiveness or the patient may have another medical condition producing ADHD-like symptoms 3,4 (i.e., infection-triggered autoimmune encephalitis, including PANS and PANDAS).

Infections and ADHD-like symptoms

Growing evidence also indicates that, in some cases, an underlying biological or physical cause (i.e. infection) can induce behaviors that mimic ADHD. The association between certain infections and ADHD has been demonstrated in numerous studies. Toto et al. concluded, “streptococcal infections and autoimmune reactions against the basal ganglia are more frequent in ADHD patients than patients in a control group.” 5

In some individuals, infectious pathogens, such as strep, coxsackie and herpes viruses, can trigger an abnormal immune response, resulting in behaviors that mimic ADHD. Patients who appear to have ADHD, may have an infection-triggered autoimmune encephalopathy, which is a treatable autoimmune disorder.

How does this happen? The immune system produces antibodies to fight the foreign germ, but some antibodies may mistakenly attack not only the germ but also healthy cells in area of the brain known as the basal ganglia. This autoimmune attack may cause brain inflammation and the onset of neuropsychiatric symptoms, such as impulsivity, hyperactivity, and concentration impairments.

A study by Giana et al. reports, “Increased levels of anti-basal ganglia antibodies and antibodies against the dopamine transporter” have been detected in patients with ADHD “supporting the role of the immune system in the disorder.” 6

ADHD medication isn’t working anymore

Patients with autoimmune-induced ADHD symptoms often complain that their ADHD medication isn’t working anymore or that it is making their symptoms worse.

Identifying whether there is a biological cause involved (i.e. an infection) is important, since treatment would then focus on immune-modulating therapies, rather than standard ADHD medications. And with proper treatment, patients may experience remission or substantial reduction of symptoms.

  1. https://www.medscape.org/viewarticle/458059_1 MedScape. Advances in the Treatment of Adult ADHD: Landmark Findings in Nonstimulant Therapy. Editorial. Margaret Weiss, MD, PhD; Robert Bailey, MD.
  2. https://www.karger.com/Article/FullText/489635#ref37 Leffa D, T, Torres I, L, S, Rohde L, A: A Review on the Role of Inflammation in Attention-Deficit/Hyperactivity Disorder. Neuroimmunomodulation 2018;25:328-333.
  3. David C. Rettew, MD. ADHD medication is not working, MDedge.com, April 4, 2014. https://www.mdedge.com/pediatrics/article/81356/adhd-medication-not-working
  4. Shim SH, Yoon HJ, Bak J, Hahn SW, Kim YK. Clinical and neurobiological factors in the management of treatment refractory attention-deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2016;70:237-244. doi:10.1016/j.pnpbp.2016.04.007 https://pubmed.ncbi.nlm.nih.gov/27103462/
  5. https://www.ncbi.nlm.nih.gov/pubmed/22956712 Toto, M., Margari, F., Simone, M., Craig, F., Petruzzelli, M. G., Tafuri, S., & Margari, L. (2015). Antibasal Ganglia Antibodies and Antistreptolysin O in Noncomorbid ADHD. Journal of Attention Disorders, 19(11), 965–970.
  6. https://www.ncbi.nlm.nih.gov/pubmed/25468771 Giana, Grazia et al. Detection of auto-antibodies to DAT in the serum: Interactions with DAT genotype and psycho-stimulant therapy for ADHD. Journal of Neuroimmunology, Volume 278, 212–222.
ADHD medication not working anymore

“Observational data from a large number of subjects show a strong association between ADHD and inflammatory and autoimmune disorders.” 2

Infections may cause ADHD and medication may not be working for ADHA
Find Out: How can an infection cause symptoms of ADHD?

Learn more about how infections can trigger neuropsychiatric symptoms

Cunningham Panel helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Researchers describe a complex case involving a 15-year-old girl, who abruptly developed multiple neurologic and psychiatric symptoms.

Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study

This nationwide, population-based, prospective cohort study examines the link between mood disorders, infections, and autoimmune disease.

Childhood infections can increase risk of mental illness in kids

Childhood infections can increase risk of mental illness in kids

Nationwide study finds both mild and severe infections can increase risk of mental disorders in children and adolescents.

  • Test Order Process
    The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms.

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