Original Investigation

Psychopharmacology

, Volume 232, Issue 16, pp 3091-3100

First online:

New onset executive function difficulties at menopause: a possible role for lisdexamfetamine

  • C. Neill EppersonAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaObstetrics and Gynecology, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania Email author 
  • , Sheila ShanmuganAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Deborah R. KimAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Sarah MathewsAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Kathryn A. CzarkowskiAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Jeanette BradleyAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Dina H. ApplebyAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Claudia IannelliAffiliated withDepartment of Psychiatry, Perelman School of Medicine at the University of PennsylvaniaPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania
  • , Mary D. SammelAffiliated withPenn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of PennsylvaniaDepartment of Epidemiology and Biostatistics, University of Pennsylvania
    • , Thomas E. BrownAffiliated withDepartment of Psychiatry, Yale University School of Medicine

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Abstract

Rationale

Reports of cognitive decline, particularly in the domains of executive functions (EFs), are common among menopausal women.

Objective

This study aims to determine the impact of the psychostimulant lisdexamfetamine (LDX) on subjective and objective cognitive function among menopausal women who report new-onset EF complaints.

Methods

Thirty-two healthy perimenopausal and early postmenopausal women experiencing mid-life-onset executive function difficulties as measured using the Brown Attention Deficit Disorder Scale (BADDS) were administered LDX 40–60 mg/day for 4 weeks in this double-blind, placebo-controlled, cross-over study. Diagnosis of lifetime ADHD was exclusionary. BADDS total and subscale scores and performance on verbal memory and working memory tasks were outcomes of interest.

Results

Analyses revealed a significant effect of LDX treatment over placebo for total BADDS scores (p = 0.0001) and for four out of the five BADDS subscales (all p < 0.004). LDX treatment also resulted in significant improvement in delayed paragraph recall (p = 0.018), but there was no significant effect of treatment on other cognitive measures. Systolic blood pressure (p = 0.017) and heart rate increased significantly (p = 0.006) when women were on LDX but remained, on average, within the normal range.

Conclusions

LDX 40–60 mg/day was well tolerated and improved the subjective measures of executive function as well as objective measures of delayed verbal recall in this sample of healthy menopausal women.

Keywords

Menopause Cognition Executive function ADHD Psychostimulant Lisdexamfetamine Brown Attention Deficit Disorder Scale Verbal memory Paragraph recall