ADHD Medications Show Promise for Menopause-Related Cognitive Complaints
A scoping review of three crossover randomized trials found that lisdexamfetamine and atomoxetine improved women's self-reported executive function during menopause, but not objective cognitive test scores. The findings suggest ADHD medications might help menopausal brain fog, though the evidence remains limited. Researchers called for larger trials and said clinicians should take cognitive symptoms seriously.
The review combined three crossover randomized trials with 60 women and two large cross-sectional surveys totaling 6,048 participants from Iceland and the U.K. In the trials, both lisdexamfetamine and atomoxetine lowered Brown ADD Scales scores versus placebo, indicating better self-rated executive function, while objective cognitive tests showed no significant benefit.
The surveys linked more ADHD symptoms to worse menopausal symptoms; in one, the intensity of ADHD symptoms, not a recorded diagnosis, was associated with greater menopause burden. The authors noted no FDA-approved therapy for menopausal brain fog and suggested that declining estradiol may reduce dopamine and norepinephrine, as in ADHD.
If confirmed, these findings could change how clinicians evaluate midlife cognitive complaints, encouraging them to take brain fog seriously rather than dismiss it. Women experiencing menopause may gain a clearer explanation and potential treatment options, though limited evidence means access and expectations should remain cautious. Larger trials could clarify whether benefits extend beyond self-report and whether ADHD medications are appropriate for broader use.