The author of the study, Forest Tennant, MD, said doctors should be encouraged to consider ADD when treating people in chronic pain.
Dr. Tennant told MedScape, “I think this is a nice new little advance in how to take care of people with pain.”
His small study found that 37.8% of the 45 participating patients met the criteria for ADD. The participants in the study completed a 16-part questionnaire focused on whether the participants had deficiencies in attention, concentration, impulsivity, coordination, temper and short-term memory. Those who answered five or more questions positively, were considered to have ADD.
Dr. Tennant noted that the findings relate only to those who have centralized pain and not those with neuropathic pain. The reason is centralized pain causes inflammation of the nervous system, and become deficient in certain compounds that relieve pain, such as catecholamine.
The pain causes a change in the sympathetic nervous system, which causes the ADD, he told MedScape. “So it puts you into this hyperactive state and at times it will also deplete dopamine both in the central nervous system and in the adrenal gland.”
“ADHD complicates the lives of patients with pain. The patient struggles with functional impairment due to pain, and ADHD adds to this dysfunction. Education often suffers because of pain; students take longer to complete their degree, and the addition of the negative impact of ADHD can make completion impossible. Family life is adversely affected, as spouses may tire of the burden of pain complaints, along with the various ADHD symptoms. Chronic pain often leads to performance issues at work or joblessness; ADHD only accentuates this problem. It is not uncommon for patients with chronic pain and ADHD, in combination with anxiety and depression, to be underfunctioning in a number of areas.”
According to Tennant, the link between pain and ADD is not new. “Physicians back in 1895 at hospitals in London said that if you have severe pain patients who need morphine, they also need a stimulant.”