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MINI REVIEW article

Front. Pharmacol.
Sec. Neuropharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1500313
This article is part of the Research Topic Pain and Pain-Related Neuropsychiatric Disorders: From Mechanistic Insights to Innovative Therapeutic Strategies View all 15 articles

Innovative therapeutic strategies using ADHD medications tailored to the behavioral characteristics of patients with chronic pain

Provisionally accepted
Satoshi Kasahara Satoshi Kasahara 1*Miwako Takahashi Miwako Takahashi 2Takashi Suto Takashi Suto 3Taito Morita Taito Morita 1HIDEAKI OBATA HIDEAKI OBATA 4Shin- Ichi Niwa Shin- Ichi Niwa 5
  • 1 Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital, Tokyo, Japan
  • 2 Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
  • 3 Department of Anesthesiology, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan
  • 4 Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
  • 5 Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Fukushima, Japan

The final, formatted version of the article will be published soon.

    Chronic pain affects a significant portion of adults and is linked to psychosocial issues, cognitive dysfunction, and psychiatric disorders, complicating treatment. Attention deficit hyperactivity disorder (ADHD) is increasingly recognized as a contributing factor to chronic pain, particularly nociplastic pain, with a notable prevalence of comorbidity between ADHD and conditions like fibromyalgia and chronic low back pain. ADHD behaviors such as impulsivity and overactivity can exacerbate pain by leading patients to seek risky treatments or discontinue care prematurely.ADHD medications are expected to alleviate pain severity by improving associated cognitive dysfunction and addressing central sensitization, a fundamental mechanism in chronic pain. Brain abnormalities in ADHD contribute to increased spontaneous activity in the anterior cingulate cortex-posterior insular pathway due to neuroinflammation, alterations in action potential firing, and changes in transmission pathways in the spinal dorsal horn. Additionally, increased norepinephrine synthesis and reduced transmission efficiency amplify nociceptive information from the periphery and facilitate central sensitization in ADHD.Beyond typical ADHD medications like central stimulants, norepinephrine reuptake inhibitors, and alpha-2 receptor agonists, various antidepressants, mood stabilizers, antipsychotics, Parkinson's disease medications, and antidementia medications have proven effective in alleviating ADHD symptoms. These medications, effective for ADHD, may offer innovative solutions for managing chronic pain by targeting both the cognitive/behavioral dysfunction and central sensitization observed in chronic pain comorbid with ADHD. Further research into these mechanisms could lead to new, more effective pharmacological treatments for chronic pain with comorbid ADHD, a condition that is often overlooked.

    Keywords: Nociplastic pain, central sensitization, Attention Deficit Hyperactivity Disorder, ADHD medication, Dopamine, Norepinephrine, pain matrix, ergomania

    Received: 23 Sep 2024; Accepted: 07 Feb 2025.

    Copyright: © 2025 Kasahara, Takahashi, Suto, Morita, OBATA and Niwa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Satoshi Kasahara, Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital, Tokyo, Japan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.