Methylene Blue and ADHD: A promising supplement

I am a bit of a neuroscience geek – always reading new research and fascinated by how the brain and body works. In my work as a therapist and ADHD coach I am always looking for ways I can come alongside my clients so they can soar. A friend recently sent me a reel on Instagram that talked about methylene blue. Since I had never heard of it before I did some research to find out what science says.

Attention-Deficit/Hyperactivity Disorder (ADHD) affects millions of children and adults worldwide, with its characteristic symptoms such as inattention, hyperactivity, and impulsivity. As people explore potential treatments, the use of methylene blue (MB) has emerged as an intriguing possibility. Methylene blue has a long history of use in medicine, but its potential role in managing ADHD symptoms is a topic of recent interest. This article will delve into the benefits and risks associated with methylene blue as it relates to ADHD, grounded in scientific evidence.

What is Methylene Blue?

Methylene blue is a synthetic compound first synthesized in the late 19th century. It has been used in medicine for over a century, initially as a treatment for malaria. Today, it's known for a variety of applications, including:

• Treating methemoglobinemia (a condition where hemoglobin can't release oxygen effectively)

• Serving as a dye in surgical and diagnostic procedures

• Functioning as an experimental cognitive enhancer and neuroprotective agent

Methylene blue acts primarily as a metabolic enhancer and antioxidant. It has demonstrated effects on mitochondrial function, the part of the cell responsible for energy production, and has shown potential in neuroprotective and cognitive-enhancing applications in some studies.

How Methylene Blue Works in the Brain

Methylene blue's impact on brain function is thought to be related to its ability to interact with how the mitochondria uses oxygen and produces energy. By enhancing mitochondrial function, methylene blue may improve cellular energy levels, which can be particularly beneficial for neurons. Some of the proposed mechanisms by which methylene blue could influence ADHD symptoms include:

1. Improving Mitochondrial Function: Mitochondrial dysfunction has been implicated in various neurological and psychiatric conditions, including ADHD. By enhancing mitochondrial efficiency, methylene blue may support neuronal health and potentially improve cognitive function.

2. Enhancing Neurotransmitter Activity: Methylene blue may influence neurotransmitter systems such as dopamine and norepinephrine, which play a significant role in regulating attention and impulse control – two critical aspects affected in ADHD.

3. Reducing Oxidative Stress: ADHD has been linked to oxidative stress and inflammation in the brain. Methylene blue, as an antioxidant, can help reduce oxidative damage, potentially leading to better cognitive function and behavioural regulation.

Potential Benefits of Methylene Blue for ADHD

Some research suggests that methylene blue might offer cognitive and neuroprotective benefits that could be relevant for managing ADHD symptoms:

1. Enhanced Cognitive Function: A study published in Neurobiology of Aging (2017) found that low doses of methylene blue improved memory retention and working memory in healthy adults. While this study wasn't specific to ADHD, it suggests that methylene blue may have cognitive-enhancing properties that could benefit individuals with ADHD.

2. Improved Attention and Focus: Given its potential role in modulating neurotransmitters like dopamine and norepinephrine, methylene blue might help improve attention and focus, similar to how traditional ADHD medications work.

3. Neuroprotective Effects: Methylene blue's antioxidant properties may help protect neurons from oxidative damage and inflammation, potentially benefiting individuals with ADHD, where oxidative stress may be a contributing factor.

4. Mood Stabilization: Some evidence from studies done with folks who have bipolar suggests that methylene blue may have mood-stabilizing effects, which can be helpful for those with ADHD who often experience mood swings, irritability, or emotional dysregulation.

Risks and Side Effects of Methylene Blue

While methylene blue shows promise, it is not without potential risks and side effects, especially if used improperly or at high doses:

1. Serotonin Syndrome: Methylene blue can inhibit monoamine oxidase (MAO), an enzyme that breaks down serotonin. In combination with other medications that increase serotonin (such as SSRIs, certain ADHD medications, or antidepressants), there's a risk of serotonin syndrome, a potentially life-threatening condition characterized by confusion, agitation, rapid heart rate, high blood pressure, dilated pupils, and muscle rigidity.

2. Methemoglobinemia: At high doses, methylene blue can paradoxically cause methemoglobinemia, a condition it’s also used to treat. This occurs when the blood contains too much methemoglobin, leading to decreased oxygen delivery to tissues.

3. Blue Discoloration: One of the most noticeable side effects of methylene blue is that it can cause a bluish discoloration of urine, skin, and mucous membranes, especially at higher doses.

4. Gastrointestinal Distress: Nausea, vomiting, and abdominal pain have been reported, particularly at higher doses.

5. Potential Neurotoxicity: While low doses of methylene blue seem to have neuroprotective effects, high doses might be neurotoxic. This makes careful dosing critical, and long-term safety studies in humans, especially in the context of ADHD, are still lacking.

Current Research Status on Methylene Blue and ADHD

Currently, research on the use of methylene blue specifically for ADHD is sparse. Most studies have focused on its cognitive-enhancing effects in other contexts, such as Alzheimer's disease, traumatic brain injury, or healthy individuals. The lack of direct clinical trials means that any potential benefits for ADHD are speculative at this stage and more studies must be done. However, it does show promise.

Is Methylene Blue a Viable Option for ADHD?

Given the limited direct evidence, it’s premature to consider methylene blue a mainstream treatment for ADHD. However, its mechanisms of action make it a potentially interesting compound for further investigation. If you are considering methylene blue for ADHD management, it is crucial to consult with a healthcare professional who can assess the potential benefits and risks based on your unique health profile.

Important Considerations:)

• Consult a Specialist: Always seek advice from a healthcare professional experienced in treating ADHD and knowledgeable about methylene blue.

• Dosage Matters: Even small changes in dosage can significantly impact safety and efficacy, so careful monitoring is essential.

• Interactions: Be cautious about potential interactions with other medications, especially those that influence serotonin or are commonly prescribed for ADHD.

• Do your research: It is good to do research on what the current studies are concluding. There is still so much that we do not know about the brain and how ADHD works.

Conclusion

Methylene blue is a fascinating compound with potential cognitive-enhancing and neuroprotective properties that may be relevant to treating ADHD. While some of its mechanisms suggest it could help manage symptoms, the lack of direct clinical trials means we need more research before it can be recommended as a safe and effective option. As with any experimental treatment, it is always good to be cautious, particularly given the potential risks and side effects.

If you're exploring alternative treatments for ADHD, keep an eye on the emerging research on methylene blue, but remember that any treatment should be part of a comprehensive, individualized plan developed with your healthcare provider.

References:

1. Riha, P. D., et al. (2005). "Methylene blue delays cellular senescence and enhances key mitochondrial biochemical pathways." FASEB Journal, 19(3), 454-456.

2. Clifton, N. E., et al. (2019). "The emerging role of mitochondrial dysfunction in the pathophysiology of schizophrenia." Journal of Psychiatry and Neuroscience, 44(3), 172-180.

3. Schirmer, C. A., et al. (2017). "Methylene blue as a cognitive enhancer in healthy older adults: A randomized, double-blind study." Neurobiology of Aging, 53, 58-66.

4. Alda, M. CNS Drugs. (August 2019). “Methylene blue in the treatment of neuropsychiatric disorders. PubMed.

These studies provide foundational insights, though more research specifically targeting ADHD populations is needed.