Pennsylvania: According to a new study, women experiencing difficulty with time management, attention, organization, memory, and problem solving – often referred to as executive functions – related to menopause may find improvement with a drug already being used to treat attention deficit hyperactivity disorder (ADHD). The study led by researchers at the Perelman School of Medicine at the University of Pennsylvania is the first to show that lisdexamfetamine (LDX) improved subjective and objective measures of cognitive decline commonly experienced in menopausal women. Results of the study are published online today in the journal Psychopharmacology.
“Reports of cognitive decline, particularly in executive functions, are widespread among menopausal women,” said lead author, C. Neill Epperson, MD,
professor of Psychiatry and Obstetrics and Gynecology at the Perelman
School of Medicine at the University of Pennsylvania, and director of
the Penn Center for Women’s Behavioral Wellness.
“There are approximately 90 million post-menopausal women living in
the US alone, and with the average age of onset occurring at 52, the
great majority of those women will live in the postmenopausal state for
at least one-third of their lives. Therefore, promoting healthy
cognitive aging among menopausal women should be a major public health
The Penn-led team administered a once-daily dose of LDX for four
weeks to 32 healthy, non-ADHD-diagnosed women between the ages of 45 and
60 experiencing difficulties with executive functions as a result of
mid-life onset menopause, and as measured using the Brown Attention
Deficit Disorder Scale (BADDS). All participants served as their own
controls by being randomly assigned to cross-over to a placebo for an
additional four weeks.
The researchers found a 41 percent overall improvement in executive
functions for women receiving LDX, compared to a 17 percent
improvement when taking placebo medication. There were also significant
improvements in four out of the five subscales for women taking LDX:
organization and motivation for work; attention and concentration;
alertness, effort, and processing speed; and working memory and
While psychostimulants such as LDX are primarily marketed for the
treatment of ADHD, they have been successful in treating cognitive
complaints in some patients including postmenopausal women. They work
by promoting the release of dopamine, which is impaired in ADHD and
other disorders characterized by executive function problems.
“Although we observed that short-term use of LDX was well tolerated
and effective in several subjective and objective areas, long-term
studies of menopausal women receiving LDX are needed, similar to those
conducted for ADHD patients,” said Epperson. “It is also important for
clinicians to confirm that a woman’s complaints of worsening memory are
in the executive function domains, are temporally related to the
transition to menopause, and are not indicative of some other
pathological cognitive impairment before prescribing a trial of LDX.”
In addition to Epperson, other Penn co-authors are Sheila
Shanmugan, Deborah R. Kim, Sarah Mathews, Kathryn A. Czarkowski,
Jeanette Bradley, Dina H. Appleby, Claudia Iannelli, and Mary D.
This project was funded in part by Shire Pharmaceuticals, the
National Institute of Mental Health, the National Institute on Aging,
and the National Institute on Drug Abuse.