Cookie Preferences
By clicking, you agree to store cookies on your device to enhance navigation, analyze usage, and support marketing. More Info
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
February 17, 2022
Roughly five of every thousand women (0.5%) have epilepsy, a neurological disorder characterized by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. Primary treatment consists of anti-seizure medications (ASMs).
Yet, research has shown that ASMs cross the human placenta. In rodents, ASMs have been shown to lead to abnormal neuronal development, and some research has pointed to the risk of adverse birth outcomes and neurodevelopmental disorders in humans. But samples have been too small for reliable conclusions, and in most cases confounding factors are not addressed.
For a more comprehensive evaluation of risk from ASMs, an international team of researchers examined a nationwide cohort using Swedish national registers that track health outcomes for virtually the entire population.
Using the Medical Birth Register, the National Patient Register, and the Multi-Generation Register, they were able to identify 14,614 children born from 1996-to 2011 to mothers with epilepsy.
Through the prescribed Drug Register, they also examined the first-trimester use of anti-seizure medications (ASMs) by these mothers. The three most frequently used ASMs "frequent enough to yield useful data“ were valproic acid, lamotrigine, and carbamazepine.
The researchers identified ADHD in offspring in one of two ways: ICD-10 (international classification of Diseases, 10th Revision) diagnoses, or filled prescriptions of ADHD medication.
Finally, they consulted the Integrated Database for Labor Market Research and the Education Register to explore potential confounding variables. These included maternal and paternal age at birth, the highest education, cohabitation status, and country of origin. They also included maternal and paternal disposable income in the year of birth and a measure of neighborhood deprivation.
Using the medical registers, they considered parental psychiatric and behavioral problems diagnosed before pregnancy, including bipolar disorder, suicide attempt, schizophrenia diagnosis, substance use disorder, and criminal convictions. They adjusted for inpatient diagnosis of seizures in the year before pregnancy to capture and adjust for indication severity.
Other covariates explored included year of birth, birth order, child sex, maternal-reported smoking during pregnancy, and use of other psychotropic medications.
After fully adjusting for all these confounders, children of mothers who were taking valproic acid were more than 70% more likely to develop ADHD than those of mothers not taking an anti-seizure medicine during pregnancy. The sample size was 699, and the 95% confidence interval stretched from 28% to 138% more likely to develop ADHD.
By contrast, children of mothers who were taking lamotrigine were at absolutely no greater risk(Hazard Ratio = 1) of developing ADHD than those of mothers not taking an anti-seizure medicine during pregnancy.
Finally, children of mothers who were taking carbamazepine were 18% more likely to develop ADHD than those of mothers not taking an anti-seizure medicine during pregnancy, but this result was not statistically significant (the 95% confidence interval ranged from 9% less likely to 52% more likely).
The authors concluded, "The present study did not find support for a causal association between maternal use of lamotrigine in pregnancy and ASD [Autism Spectrum Disorder] and ADHD in children. We observed an elevated risk of ASD and ADHD related to maternal use of valproic acid, while associations with carbamazepine were weak and not statistically significant. Although we could not rule out all potential confounding factors, our findings add to a growing body of evidence that suggests that certain ASMs (i.e., lamotrigine) may be safer than others in pregnancy."
Kelsey K. Wiggs, Martin E. Rickert, Ayesha C. Sujan, Patrick. Quinn, Henrik Larsson, Paul Lichtenstein, A. Sara Oberg, and Brian Onofrio, "Antiseizure medication use during pregnancy and risk of ASD and ADHD in children" Neurology(2020),95:e3232-e3240, published online,https://doi.org/10.1212/WNL.0000000000010993.
Boredom is more than just feeling restless or under-stimulated — it’s a negative emotional state that arises when activities feel meaningless or dull. Researchers increasingly view it as functional: an internal signal pushing people to seek more rewarding and meaningful experiences. But for some, that signal becomes chronic and overwhelming.
People who are highly prone to boredom face a range of psychological and behavioral consequences, including anxiety, depression, difficulty identifying their own emotions (alexithymia), impulsivity, and physical complaints. These struggles often surface in harmful behaviors: overeating, substance use, compulsive internet use, and gambling.
For people with ADHD, boredom can cross into genuine distress. Many describe it as “torture” or “an itchy coat you can’t scratch”, language that conveys not mild discomfort but an urgent, almost unbearable need to escape. This makes sense given that ADHD involves core difficulties with attention, arousal regulation, and motivation, all of which make sustained engagement harder and boredom far more likely.
The Study:
A recent meta-analysis of 18 studies involving more than 22,000 participants confirmed a moderately strong and consistent positive association (an overall effect size of r = 0.40) between ADHD and self-reported boredom. All but one study found significant results, and there was no evidence of publication bias.
“While the relationship between ADHD and boredom may seem obvious,” the authors state, “this has paradoxically led to the phenomenon being understudied.”
Despite how significant this connection appears to be, the researchers noted it has attracted surprisingly little scientific attention; a gap they attribute to a widespread assumption that boredom in ADHD is simply a byproduct of inattention or impulsivity, and therefore not worth studying on its own terms. They push back on that view, arguing that boredom may be a more fundamental part of the ADHD experience: a bridge between atypical brain function and the behavioral, emotional, and cognitive difficulties that shape long-term outcomes.
The Take-Away:
Ultimately, addressing the profound boredom experienced by individuals with ADHD requires a multifaceted approach that goes beyond simply treating inattention. Researchers emphasize the need for rigorous studies to determine if stimulant medications actively reduce this intense boredom by repairing underlying brain mechanisms, rather than just as a side effect of improved focus. Beyond medication, tailored psychological therapies may offer promise; psychoeducation can help individuals reframe boredom as a biological signal rather than a personal failure or character flaw.
Additionally, another approach suggests that rather than solely focusing on treating the individual, systemic issues must be addressed, such as the effects of low-stimulation environments. For example, prioritizing a better "person-environment fit" through smaller class sizes, flexible academic pacing, and/or offering highly stimulating, novel tasks, schools and workplaces can offer meaningful relief from the chronic distress of ADHD-related boredom.
A new study from Japan suggests that infants born with craniosynostosis are significantly more likely to be diagnosed with ADHD later in childhood. Craniosynostosis is a condition in which the bony plates of the skull fuse prematurely, leading to increased intracranial pressure.
The Background:
Craniosynostosis affects roughly one in every 2,000 births. When the skull’s natural seams close prematurely, it can restrict brain growth and increase intracranial pressure, potentially reducing blood flow to the brain. Because the condition is relatively rare, it has been difficult to study at scale until now.
The Study:
To overcome this, researchers tapped into a large Japanese insurance database compiled by JMDC, Inc., which holds records on around 20 million people, or about 15% of Japan’s population. Drawing on two decades of data, the team tracked over 338,000 mother-child pairs. Children with related genetic syndromes or chromosomal conditions such as Down syndrome were excluded to keep the focus on craniosynostosis itself.
Of the children studied, around 1,145 had craniosynostosis, and 7,325 were diagnosed with ADHD. After accounting for factors like sex, birth year, maternal age, mental health history, pregnancy infections, and birth complications, children with craniosynostosis were found to have roughly 2.4 times the risk of a subsequent ADHD diagnosis compared to those without it.
To test whether shared family genetics or home environment might be driving the association rather than the skull condition itself, the researchers conducted a separate analysis among siblings. The elevated risk remained at 2.2 times. The consistency of the finding across both analyses strengthens the case for a genuine biological link.
The Results:
The results point to raised intracranial pressure and restricted cerebral blood flow as plausible mechanisms, though the study’s observational design means causation cannot be confirmed. Ultimately, these findings highlight the need for proactive, long-term care strategies for those born with craniosynostosis. By establishing a solid link between premature skull fusion and a significantly higher risk of ADHD, the research demonstrates that medical care for this condition should not end once the skull's physical structure is addressed.
The Takeaway:
Pediatricians, neurologists, and parents can use this data to implement early, routine behavioral and developmental screening for these children as they grow. This additional support would ensure that those who do develop ADHD can receive timely interventions, educational aids, and therapies, ultimately improving their long-term developmental outcomes.
Children and adolescents with ADHD come into contact with child welfare services (CWS) far more often than their peers. There are many contributing factors to consider, including the fact that hyperactivity and impulsivity frequently lead to behaviors that are considered disruptive and cause academic and social difficulties. Many of these children are also growing up in households marked by parental conflict and/or single-parent arrangements. All of these circumstances can compound vulnerability and, historically, increase the likelihood of CWS involvement.
Background:
In Norway, Child Welfare Services operate at the municipal level and are legally required in every local authority. Their scope spans investigation, family support, and, where necessary, out-of-home placement and ongoing monitoring. Grounds for intervention include abuse, neglect, behavioral or psychosocial difficulties, and inadequate care-giving. Norwegian CWS works closely with health, education, and social services and places a strong emphasis on keeping families together. Compared with systems in countries such as the United States, Poland, Romania, and the Czech Republic, the Norwegian approach sets a lower bar for intervention and leans toward home-based support, while setting a higher bar for out-of-home placements. This model is shared by other Nordic countries, as well as Germany and the United Kingdom.
Research into whether ADHD medication affects child welfare caseloads is remarkably sparse. A single Danish study previously found that medication treatment accounted for much of an observed decline in foster care cases, but no study had examined medication’s broader impact on CWS involvement, covering both supportive interventions and out-of-home placements.
Norway’s universal single-payer health system and comprehensive national registers make population-wide research of this kind feasible. Drawing on these resources, a Norwegian research team set out to test whether ADHD medication reduces children’s contact with CWS and their need for out-of-home placement.
The Study:
This study included all 5,930 children and adolescents aged 5 to 14 who received a clinical ADHD diagnosis from Child and Adolescent Mental Health Services between 2009 and 2011. Each was followed for up to 4 years post-diagnosis, the upper age limit being 18, at which point CWS jurisdiction ends. This group was compared with more than 53,000 peers who had no CWS contact during the same period.
The results showed a meaningful, though not dramatic, association between medication and reduced CWS contact. At one year, treated children had approximately 7% fewer contacts with CWS; by two years, that figure had risen to around 12%. The effect then narrowed, settling at roughly 7–8% reductions at the three- and four-year marks.
The picture for out-of-home placements is considerably less convincing. The research team highlighted a 3% reduction at two-year follow-up, but this finding barely crossed the threshold of statistical significance, and no effect was observed at the one-, three-, or four-year follow-up points.
The Take-Away:
The authors concluded that pharmacological treatment for ADHD is associated with reductions in both supportive CWS services and out-of-home placements among children affected by clinicians’ prescribing decisions in Norway. A more cautious reading of the same data, however, would emphasize an overall reduction in CWS contact of roughly 8%, while treating the out-of-home placement finding as, at best, inconclusive.
_logo%201.svg)
