Latest / Morning Medical with Dr. Chow / ADHD Medications, Womb Transplant Success, and GLP-1 Research

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ADHD Medications, Womb Transplant Success, and GLP-1 Research · Morning Medical with Dr. Chow

• 0:00
  Welcome to Morning Medical with Dr.
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  Chow, where we bring you the latest in medical and health news from around the globe.
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  I'm Dr.
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  Chi-Ming Chow, your host, and today we're diving into some fascinating developments in
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  the world of medicine.
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  As we celebrate our 200th episode, let's explore the intricacies of recent findings on
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  attention deficit hyperactivity disorder medications and their effects on cardiovascular
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  health.
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  A recent systematic review published in Lancet Psychiatry has shed light on the cardiovascular
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  effects of medications used to treat attention deficit hyperactivity disorder, or ADHD.
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  The study, led by Dr.
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  Luis Farhat from the Universidade de São Paulo in Brazil, analyzed data from over one hundred
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  double-blind randomized trials.
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  These trials evaluated the short-term impacts of both stimulants and selective noradrenaline
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  reuptake inhibitors on blood pressure and pulse rates.
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  The findings revealed modest increases in systolic and diastolic blood pressure, as well
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  as pulse rate, among individuals taking these medications.
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  For instance, in children, methylphenidate was associated with a systolic blood pressure rise
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  of 1.81 millimeters of mercury, while in adults, amphetamines resulted in an increase of
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  2.3 millimeters of mercury.
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  Similarly, pulse rates saw a notable uptick with atomoxetine in children and viloxazine in
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  adults.
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  While these changes might appear small, the research highlights that some individuals could
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  experience significant cardiovascular effects, potentially tipping into abnormal ranges.
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  This underscores the importance of monitoring blood pressure and pulse in patients using any
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  pharmacological intervention for ADHD, not just stimulants.
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  Interestingly, guanfacine showed an opposite trend by reducing blood pressure and pulse in
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  children.
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  Dr.
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  Samuele Cortese, co-author of the study from the University of Southampton, emphasized the
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  need for future research to identify individuals who might be at higher risk of
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  these cardiovascular changes.
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  This could pave the way for precision medicine approaches, offering personalized treatment
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  plans to minimize risks.
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  Furthermore, Dr.
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  Steven Pliszka from the University of Texas Health Science Center at San Antonio noted that
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  if a patient's blood pressure or pulse reaches borderline abnormal levels, transitioning to
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  another ADHD medication should be considered.
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  The differences in mechanisms between stimulants, noradrenaline reuptake inhibitors,
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  and alpha agonists suggest that switching medications could mitigate these unwanted
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  effects.
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  In summary, while clinicians should be vigilant about the cardiovascular side effects of ADHD
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  medications, they should not shy away from their use.
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  The benefits of treating ADHD often outweigh these risks, provided that regular monitoring
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  is in place.
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  This study serves as a reminder of the ongoing need for comprehensive cardiovascular
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  assessments in patients undergoing ADHD treatment.
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  Let's talk about some exciting new research that might change the way we think about
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  certain diabetes medications and their broader health benefits.
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  Two major studies published in JAMA Neurology have suggested that GLP-1 drugs, like Ozempic
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  and Wegovy, which are primarily used for managing Type 2 diabetes and aiding in weight
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  loss, could also significantly reduce the risk of Alzheimer's disease and dementia.
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  The studies found that these GLP-1 medications were associated with a 33 percent reduction in
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  the risk of dementia among people with Type 2 diabetes.
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  Interestingly, another class of diabetes medications known as SGLT2 inhibitors showed an
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  even greater potential benefit, reducing the risk by 43 percent.
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  This is quite promising as it opens up new avenues for potentially preventing cognitive
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  decline in a population that is already at risk.
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  Dr.
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  Serena Guo, the senior author of one of the studies and a pharmacoepidemiologist at the
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  University of Florida College of Pharmacy, emphasized that while these initial findings
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  are promising, more research is needed.
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  She noted that this is one of the first real-world studies to thoroughly evaluate the
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  impact of neuroglucose-lowering drugs on preventing Alzheimer's disease and related
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  dementias.
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  The mechanisms by which these drugs might protect the brain are not yet fully understood,
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  but several theories are being explored.
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  It's thought that GLP-1 medications might help by lowering glucose levels and body weight,
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  both known risk factors for dementia.
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  Additionally, they may reduce inflammation, improve insulin function, and even promote the
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  growth of new brain cells.
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  Moreover, these drugs might enhance blood flow to the brain and reduce oxidative stress, all
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  of which can contribute to reducing cognitive decline.
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  Dr.
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  Sharon Cohen, a neurologist in Toronto, remarked on the significance of these findings.
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  She highlighted the growing body of evidence supporting the use of glucose-lowering drugs
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  for Alzheimer's disease, noting that these studies provide further support for their
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  potential neuroprotective effects.
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  Dr.
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  Cohen suggested that these medications might not only be beneficial for Alzheimer's but
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  could also hold promise for conditions like Parkinson's disease and other forms of
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  dementia.
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  As always, it's important to approach these findings with cautious optimism.
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  While the potential for GLP-1 and SGLT2 inhibitors to reduce the risk of Alzheimer's is
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  exciting, further research is necessary to fully understand their benefits and safety
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  profiles.
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  Nonetheless, this research adds a new dimension to our understanding of these medications and
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  their potential impact on brain health.
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  Today, we're celebrating an extraordinary medical milestone in the United Kingdom with
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  the birth of a "miracle" baby girl to a mother who received a womb transplant.
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  Grace Davidson, a thirty-six-year-old woman, was born without a functioning uterus due to a
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  condition known as Mayer-Rokitansky-Küster-Hauser syndrome.
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  In two thousand twenty-three, Grace underwent a groundbreaking womb transplant, receiving the
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  uterus from her sister, Amy Purdie.
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  This event marked the UK's first successful womb transplant, and now, two years later,
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  Grace has given birth to her first child.
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  The baby girl, named Amy after her aunt who donated the womb, was born in February and
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  weighed just over two kilograms.
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  Grace described the experience of holding her daughter for the first time as "incredible" and
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  "surreal." She and her husband, Angus, who live in north London but are originally from
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  Scotland, are overjoyed and hope to have a second child using the transplanted womb.
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  After the birth of a second child, the transplanted womb will be removed, allowing
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  Grace to stop taking immunosuppressants, which carry long-term health risks.
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  The surgical team involved in this pioneering procedure has since conducted three additional
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  womb transplants using deceased donors.
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  Their goal is to perform a total of fifteen transplants as part of an ongoing clinical
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  trial.
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  Each transplant procedure is complex, requiring a large team of medical professionals and
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  significant resources.
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  The charity Womb Transplant UK, which funded Grace's operation, continues to support this
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  innovative work, providing hope to many women in the UK who lack a functioning uterus.
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  Grace's journey to motherhood has been a remarkable one, filled with both medical and
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  emotional challenges.
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  Her condition, Mayer-Rokitansky-Küster-Hauser syndrome, meant she had functioning ovaries but
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  no uterus.
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  Initially, Grace hoped her mother could be the donor, but when that was not possible, her
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  sister Amy stepped forward.
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  Following extensive counseling and medical assessments, the transplant surgery took place,
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  lasting seventeen hours.
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  For Grace, the ability to carry her own child was of immense importance, despite the
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  availability of alternatives like surrogacy or adoption.
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  "I have always had a mothering instinct," she shared, "but for years, I had been suppressing
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  it because it was too painful to go there." After the transplant, Grace experienced her
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  first menstrual period and became pregnant on her first attempt at in vitro fertilization.
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  The pregnancy, filled with moments of wonder such as feeling her baby's first kick, was
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  described by Grace as "really special."
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  The surgical team, led by Dr.
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  Isabel Quiroga at the Churchill Hospital in Oxford, highlighted the life-enhancing nature
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  of the procedure.
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  Dr.
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  Quiroga emphasized that the risks involved were outweighed by the profound benefits of enabling
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  Grace to become a mother.
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  This sentiment was echoed by Prof.
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  Richard Smith, a gynecological surgeon at Imperial College Healthcare, who has been
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  researching womb transplantation for over two decades.
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  Prof.
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  Smith expressed his team's excitement over the birth of baby Amy, seeing it as a beacon of
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  hope for the approximately fifteen thousand women in the UK of childbearing age who do not
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  have a functioning uterus.
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  Of these women, around five thousand were born without a womb.
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  The success of Grace's transplant and subsequent pregnancy showcases the potential of
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  this procedure to transform lives, offering new possibilities for women who previously faced
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  limited options for motherhood.
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  The birth of baby Amy not only marks a medical triumph but also a deeply personal victory for
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  Grace and her family.
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  Grace's husband, Angus, expressed profound gratitude towards his sister-in-law Amy,
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  calling their decision to name their daughter after her a "no-brainer." The baby's middle
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  name, Isabel, honors Dr.
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  Isabel Quiroga, the surgeon who played a pivotal role in the transplant.
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  This story of sisterly love and medical innovation serves as an inspiring example of
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  what can be achieved when science, compassion, and determination come together.
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  A recent study published in JAMA Pediatrics has brought to light the concerning effects of
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  prenatal opioid exposure on newborn brain development.
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  This research, a part of the Outcomes of Babies with Opioid Exposure study, involved 173
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  newborns with antenatal opioid exposure and 96 without such exposure, focusing on the second
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  and third trimesters of pregnancy.
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  The findings revealed that infants exposed to opioids in utero had significantly smaller
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  total brain volumes compared to unexposed controls.
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  Dr.
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  Catherine Limperopoulos and her colleagues from Children's National Hospital in Washington,
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  D.C., led this prospective study, which controlled for several factors such as birth
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  weight, postmenstrual age at magnetic resonance imaging, and maternal characteristics.
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  The results indicated that the total brain volume of opioid-exposed newborns was nearly
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  five percent smaller than that of those not exposed.
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  This difference was seen across various brain regions, including the cortical gray matter,
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  deep gray matter, white matter, cerebellum, brainstem, and the amygdala.
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  The study also explored how different types of opioid exposure affected brain volume.
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  Notably, methadone-exposed infants had significantly smaller white matter volumes,
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  while those exposed to buprenorphine showed reductions in the volume of the right amygdala.
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  These findings suggest that the type of opioid used during pregnancy can have specific impacts
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  on brain development.
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  Dr.
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  Yao Wu, the lead author, emphasized that while prenatal opioid exposure is known to be
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  associated with adverse neurodevelopmental consequences, the precise effects on the
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  developing brain have remained poorly understood until now.
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  The study's findings of impaired regional brain growth in exposed newborns may serve as early
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  biomarkers for later neurodevelopmental dysfunction.
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  Editorialists Dr.
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  Nethra Madurai and Dr.
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  Lauren L.
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  Jantzie from Johns Hopkins University School of Medicine highlighted the importance of shifting
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  focus beyond withdrawal symptoms in newborns affected by prenatal opioid exposure.
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  They advocate for a deeper understanding of the long-term impacts on brain development, which
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  could lead to meaningful interventions and improved outcomes for these children.
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  While the study lays the groundwork for future research, it also acknowledges certain
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  limitations, such as the lack of detailed data on the amount and duration of opioid exposure
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  and not accounting for maternal mental health disorders.
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  Despite these limitations, the research underscores the vulnerability of the developing
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  brain and the need for continued investigation into effective interventions.
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  The study was supported by the National Institutes of Health through the HEAL
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  Initiative, with no relevant conflicts of interest reported by the editorialists.
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  As we continue to understand the broader implications of prenatal opioid exposure, this
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  research represents a crucial step in addressing the challenges faced by children
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  born into the opioid epidemic.
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  In a remarkable recognition of scientific achievement, Canadian researcher Dr.
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  Daniel Drucker has been awarded the 2025 Breakthrough Prize in Life Sciences.
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  This accolade honors his discovery of the glucagon-like peptide-1, or GLP-1 hormone,
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  which is pivotal in diabetes and obesity medications such as Ozempic, Wegovy, and
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  Mounjaro.
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  These medications have transformed the lives of millions worldwide.
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  Dr.
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  Drucker, an esteemed endocrinologist and clinician-scientist at the University of
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  Toronto and the Lunenfeld-Tanenbaum Research Institute at Sinai Health, shares the three
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  million dollar prize with four colleagues from the United States and Denmark.
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  Together, they've contributed to the development of these groundbreaking drugs,
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  manufactured by Novo Nordisk and Eli Lilly.
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  The Breakthrough Prizes, often dubbed the 'Oscars of Science,' are awarded in various
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  categories, including Fundamental Physics and Mathematics, alongside Life Sciences.
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  The awards aim to celebrate the marvels of our scientific era, and Dr.
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  Drucker's work certainly exemplifies this.
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  Dr.
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  Drucker began his journey in the 1980s, studying genetic sequencing of glucagon-like
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  peptides in a Boston lab.
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  He returned to Canada to continue his pivotal research at the University of Toronto.
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  His discoveries about GLP-1's role in inhibiting food intake and its potential
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  applications in treating heart disease, inflammation, and kidney disease have had a
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  profound impact on medical science.
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  Dr.
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  Drucker also highlighted the significance of these awards for young scientists and trainees.
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  He remarked that recognition from the scientific community is not only an honor but
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  also an inspiration for future generations of researchers.
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  Beyond diabetes and obesity management, GLP-1 medications have been shown to reduce the risk
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  of heart attacks and strokes, aid in treating diabetic kidney disease, and even help with
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  conditions like obstructive sleep apnea and arthritis.
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  Ongoing trials are exploring their potential benefits for Parkinson's disease, Alzheimer's
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  disease, and substance use disorders.
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  Dr.
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  Drucker expressed excitement about the future research directions, particularly in
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  understanding how GLP-1 reduces inflammation and benefits various organs like the brain,
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  blood vessels, and kidneys.
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  This ongoing research could unlock even more applications for GLP-1 medications.
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  As we conclude this episode, I want to express my gratitude to all our listeners for joining
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  us on this journey through the latest in medical and health news.
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  We hope you found today's episode insightful as we explored groundbreaking research and medical
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  advancements.
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  Until next time, stay informed and take care of your health.