A scoping review suggests both stimulant and non-stimulant medications may improve executive functioning.
Many perimenopausal women experience cognitive changes such as forgetfulness or trouble concentrating, which are commonly referred to as brain fog.
There are no approved pharmacological interventions for these changes, but the findings of a new scoping review suggest existing ADHD drugs could be beneficial in these women.
Studies were included in the review if they investigated the effects of lisdezamfetaime and/or atomoxetine on cognition and ADHD symptom severity. Women were 45-60 years of age with their final menstrual period coming in the last 10 years were included, while women with sleep disorders, surgical menopause, primary ovarian insufficiency, premature or early menopause, or a previous or current cancer diagnosis were excluded.
The review suggested that both stimulant and non-stimulant ADHD medications were associated with significant improvements in self-reported executive function, as measured by reductions in the Total Brown Attention Deficit Disorder Scale compared to women treated with placebo.
However, the medications had no significant effect on objective measures of cognition, including working memory and sustained attention tests. There were also inconsistent findings regarding the potential impact of a formal ADHD diagnosis on somatic and psychological complaints.
Consequently, the researchers suggested that the effects of the ADHD medications on executive function found in the study may be through altering the catecholaminergic transmission that is known to be affected by menopause.
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“Many women at perimenopause notice changes in focus, memory, and organisation that look a lot like ADHD, and the two can be hard to tell apart,” said Jennifer Tat, a medical student from the University of Tennessee Health Science Center in Memphis who was the lead author on the new research.
“Our review found early signs that ADHD medications may help women feel more on top of their daily lives. While it’s too early to recommend these medications, a quick screen for ADHD symptoms is a simple step that could help women get the right care.”
The researchers hope that their findings could lead to the use of nonhormonal therapies for perimenopausal executive dysfunction, although they acknowledge that further research is needed to determine whether it is safe and effective to use medications for this purpose.
Dr Stephanie Faubion, medical director of The Menopause Society, said that the brain fog women may experience with menopause is usually temporary, and does not result in any permanent changes.
“However, it can last long enough to disrupt work and daily routines and cause significant stress and anxiety. That’s why studies like this are important in helping to identify additional options for symptoms,” she said.
The study was presented at the 2026 Annual Meeting of the Menopause Society, held in San Diego, California, from 20 to 24 October.
