ADHD Medications Linked to Reduced Maladaptive Daydreaming and Mind-Wandering in Adults

Adults with attention deficit hyperactivity disorder (ADHD) showed significant reductions in maladaptive daydreaming and mind-wandering during 12 weeks of treatment with either methylphenidate or atomoxetine, according to a prospective multicenter follow-up study published in BMC Psychiatry. The reductions were largest during the first four weeks of treatment, and the two medications did not differ significantly from each other in their associations with these changes over time.

Both phenomena have been reported to be elevated in ADHD, but how medical treatments affect them has remained unclear. The new study was designed to prospectively examine the extent to which methylphenidate, a stimulant, and atomoxetine, a non-stimulant, are associated with changes in these two dimensions.

The researchers enrolled 85 drug-naive adults with ADHD—that is, patients who had not previously received ADHD medication—along with 53 healthy controls. The patients were clinically followed for 12 weeks. At baseline and again at 4-, 8-, and 12-week follow-ups, participants completed the Adult ADHD Self-Report Scale (ASRS), the Maladaptive Daydreaming Scale (MDS), and the Mind-Wandering Questionnaire (MWQ), allowing the investigators to track symptom and questionnaire trajectories across the treatment period.

At baseline, MDS and MWQ scores were significantly higher in the patients with ADHD than in the healthy controls, consistent with the view that both excessive daydreaming and attentional drifting are prominent features of the disorder in adults seeking treatment.

Over the 12-week follow-up, the treated patients showed significant reductions in all three measures: ASRS, MDS, and MWQ scores all decreased (p < 0.001). The largest reductions occurred in the first four weeks. The two dimensions then followed different time courses: MDS scores continued to decrease through week 12, whereas MWQ scores remained similar between weeks 8 and 12, suggesting that maladaptive daydreaming and mind-wandering respond differently over the course of treatment.

When the investigators compared the two medications, they found no significant difference between methylphenidate and atomoxetine in terms of changes over time for any of the three measures (ASRS: F = 1.606, p = 0.209; MDS: F = 0.886, p = 0.384; MWQ: F = 1.759, p = 0.182). In other words, both the stimulant and the non-stimulant were associated with significant reductions in maladaptive daydreaming and mind-wandering, with no statistical evidence that one outperformed the other on these outcomes.

The study also examined whether baseline severity predicted the degree of improvement. Higher baseline MDS scores were associated with greater reductions in both MDS and MWQ scores. The association between baseline maladaptive daydreaming and MDS reduction remained significant after adjustment for baseline mind-wandering (F = 27.942, p < 0.001, ηp² = 0.171), and the association with MWQ reduction remained significant after adjustment for baseline ASRS (F = 10.135, p < 0.001, ηp² = 0.070).

The picture was more complex for core ADHD symptoms. Although higher baseline MDS was associated with greater ASRS reduction in the unadjusted analysis, this association was no longer significant after adjustment for baseline MWQ (F = 2.341, p = 0.109, ηp² = 0.017). Baseline MWQ, by contrast, remained significantly associated with ASRS reduction (F = 14.224, p < 0.001, ηp² = 0.095). The authors interpret these patterns as suggesting that maladaptive daydreaming and mind-wandering are related but distinguishable dimensions, and that mind-wandering may be more closely associated with changes in core ADHD symptoms during treatment.

The researchers caution that the study was not randomized and that potential confounding cannot be excluded, so comparisons between the medication groups should be interpreted cautiously. The findings are associations observed in a prospective observational follow-up of treated patients, not evidence from a randomized trial, and they do not establish that either medication causes reductions in maladaptive daydreaming or mind-wandering. Within those limits, the study adds that both stimulant and non-stimulant treatment in adult ADHD were accompanied by significant, early-onset reductions in both dimensions, with maladaptive daydreaming continuing to decline over the full 12 weeks while mind-wandering plateaued after week 8.

Subject of Research: The association of methylphenidate and atomoxetine treatment with changes in maladaptive daydreaming and mind-wandering in adults with ADHD

Article Title: The effect of medical treatments on maladaptive daydreaming and mind-wandering in adult attention deficit hyperactivity disorder: a multicenter follow-up study

Article References: Kazğan Kılıçaslan, A., Korkmaz, U., Kılıçaslan, U., Tabara, M. F., & Yıldız, S. (2026). The effect of medical treatments on maladaptive daydreaming and mind-wandering in adult attention deficit hyperactivity disorder: a multicenter follow-up study. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08823-2

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08823-2

Keywords: ADHD, adults, maladaptive daydreaming, mind-wandering, methylphenidate, atomoxetine, stimulant medication, non-stimulant medication, prospective follow-up study, BMC Psychiatry, ASRS, symptom reduction