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My mother has taken Ritalin for adult ADD for over 10 years. This afternoon we found out she just had a minor stroke. There is evidence of possible prior strokes even though strokes do not run in the family, she is not elderly, and she has no history of heart disease. Could her ADD be due to tiny strokes? And could stimulant medication worsen whatever neurovascular condition she has? And could psychiatry do more than just treat the symptoms of her ADD?



Answered by: David Gutman

I hope that your mother is recovering well.

Although strokes can affect a person's ability to pay attention, ADHD typically starts in childhood, when it is rare to have a stroke. Stimulants, because they can increase heart rate and blood pressure, can aggravate neurovascular conditions. The risks and benefits of using them depend on the particular situation.

As in many other medical fields, "just treating the symptoms" happens more often then curing the illness. Fortunately, psychiatry has come a long way in the last 100 years in its ability to help relieve suffering. Until we can find cures for psyciatric illness, however, we have to make the best use of the treatments that exist and continue to find new ones.

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David Gutman, M.D.
Director of Psychopharmacology 

Dr. David Gutman is an Assistant Clinical Professor in the Department of Psychiatry at Columbia University and Director of Psychopharmacology, Columbia University Medical Center Eastside.

Dr. Gutman received his B.A. from the University of Pennsylvania, his medical degree from New York University, and was a resident and chief resident in psychiatry at Columbia University/New York State Psychiatric Institute. He then completed a three-year research fellowship at Columbia University/New York State Psychiatric Institute where he worked on neurophysiological systems underlying anxiety diso...
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