Dr. John Kruse

04/08/2026

The medications used most commonly to keep people awake and alert - the stimulants - have serious risks for abuse, addiction, psychosis and cardiac problems. Oveporexton, a non-stimulant that works on the orexin system, is likely to be approved for narcolepsy later this year. But it may well usher in a whole new treatment approach for daytime lethargy and brain fog from a variety of causes, since initial reports indicate that it is both more effective and safer than older options.

Free link for non-members of Medium:
https://medium.com/invisible-illness/new-medications-for-staying-alert-254e29ce100f?sk=9ae0913a28643f47421e9cb450372023

https://medium.com/invisible-illness/new-medications-for-staying-alert-254e29ce100f

Oveporexton provides a novel way to treat narcolepsy, and may help with other causes of daytime drowsiness.

04/06/2026

Weekly Q&A - 07 Apr 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/u8NJuurIX8k

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 6:00am Hawaii / 6:00pm Central European
www.youtube.com/

Video released this week:

- Oveporexton - The First Orexin Receptor Activator
https://youtu.be/qUu76gKkBTk

After a short recap of the video, I’ll be available for questions on this topic or any other related to Mental Health.

- Oveporexton - The First Orexin Receptor Activator:

Takeda Pharmaceutical's oveporexton is likely to be approved in 2026 as the first orexin receptor agonist. Although the application is only for its use in narcolepsy, it is likely that oveporexton will also be used off label to address a variety of problems with feeling sedated/fatigued/unfocused - and that includes ADHD.

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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.Weekly Q&A - 07 Apr 2026

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

04/01/2026

For decades people have questioned the validity of psychiatric diagnoses - whether they truly represent separate, distinguishable conditions. Despite valiant efforts, psychiatric researchers, until now, have failed to identify biomarkers tied to individual conditions. Rather than looking for biological variables uniquely tied to a condition, a new study took an opposite approach: plowing through vast piles of information on brain connectivity to see whether brains clustered along discrete, unusual patterns of wiring. They found three distinct brain wiring patterns among children with ADHD, each distinct from the others and from children without ADHD. These ADHD biotypes matched very poorly with our conventional approach to subdividing presentations of ADHD. But research similar to this is likely to revolutionize psychiatric diagnosis and treatment.

Free link for non-members of Medium:
https://medium.com/invisible-illness/neuroscience-provides-new-psychiatric-biomarkers-f36734556335?sk=c6fdd826ab93a6a9ebdb1acf08f89ba6

https://medium.com/invisible-illness/neuroscience-provides-new-psychiatric-biomarkers-f36734556335

Biology reveals three kinds of ADHD — just not the types we thought.

03/30/2026

Weekly Q&A - 31 Mar 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/0iRWd7vJsNo

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 6:00am Hawaii / 6:00pm Central European
www.youtube.com/

Video released this week:

- The 3 ADHD Biotypes
https://youtu.be/fw96U3H4bcQ

After a short recap of the video, I’ll be available for questions on this topic or any other related to Mental Health.

- The 3 ADHD Biotypes: A recent study used patterns of neural connectivity to detect three distinct patterns among more than 1000 children with ADHD. These patterns of connectivity also differed from those of children without ADHD, meaning that it could serve as a biomarker. Although the study labeled the three biotypes inattentive, hyperactive/impulse, and severe/emotional dysregulation, there was very poor correlation with our current subtypes of ADHD (combined, inattentive and hyperactive/impulsive). Biotypes that actually correspond to underlying differences in brain wiring are expected to lead no just to more precise diagnosis, but more effective treatment as well.
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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

03/24/2026

Weekly Q&A - 24 Mar 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/qJdfZNPzGQ4

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 6:00am Hawaii / 5:00pm Central European
www.youtube.com/

Video released this week:

- Stimulants and Bone Health
https://youtu.be/oVghHjowyqg

After a short recap of the video, I’ll be available for questions on this topic or any other related to Mental Health.

- Stimulants and Bone Health:

Bones aren't just inert scaffolding - they're being continually broken down and remodeled. Various diseases, poor nutrition and other factors can increase the extent of break down to building up, and stimulant medications are among those additional factors. While rodent and laboratory data show negative effects of stimulants on bone growth and strength, the real world data in ADHD patients is less clear cut, and stimulants don't appear to have a major impact on bone weakening for most individuals.

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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

03/23/2026

Bones aren't just inert structural support, they're living, growing tissue. Although age and genetics are the largest contributors to osteoporosis, or bone loss, a number of diseases (kidney, parathyroid, thyroid), medications (prednisone, proton pump antacids, and others), and lifestyles (cigarette smoking, heavy alcohol intake, sedentariness) can all contribute to bone destruction outpacing bone generation, leading to more fragile, breakable bones.
Free link for non-members of Medium:
https://medium.com/.../are-medications-harming-bones...

03/16/2026

Weekly Q&A - 17 Mar 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/fY3aRKHmdUQ

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 6:00am Hawaii / 5:00pm Central European
www.youtube.com/

Video released this week:

- Proposed DSM Changes
https://youtu.be/fmBUjtd6bas

After a short recap of the video, I’ll be available for questions on this topic or any other related to Mental Health.

- Proposed DSM Changes:

Psychiatric diagnosis is about to undergo a major revision. The planned changes to DSM will start to align mental health conditions more clearly within the framework that every condition is the product of a specific biological brain interacting with a physical and psychosocial environment. This should lead to major revisions in diagnostic categories, resulting in more accurate and valid labels, as well as leading to more effective treatments.

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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

03/15/2026

Psychiatric diagnosis is about to undergo a major revision. The planned changes to DSM will start to align mental health conditions more clearly within the framework that every condition is the product of a specific biological brain interacting with a physical and psychosocial environment. This should lead to major revisions in diagnostic categories, resulting in more accurate and valid labels, as well as leading to more effective treatments.

Free link for non-members of Medium:

Revisions to mental health diagnosis will affect everyone who has or might have a condition

03/09/2026

Weekly Q&A - 10 Mar 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/7BJopWsA0ug

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 6:00am Hawaii / 5:00pm Central European
www.youtube.com/

Video released this week:

- Cortisol and ADHD - Tired? It's Not Adrenal Fatigue
https://youtu.be/ugiLpu-VFGM

After a short recap of the video, I’ll be available for questions on this topic or any other related to Mental Health.

- Cortisol and ADHD - Tired? It's Not Adrenal Fatigue

Circadian rhythms influence cortisol release but it is also pumped out by the adrenal gland (along with norepinephrine and epinephrine) in response to stress. Cortisol helps make more glucose available to muscles and fat cells; damps down inflammation; and affects the brain.

Many mental health conditions are associated with abnormal cortisol rhythms and abnormal responses to stress. Meta-analyses indicate for those with ADHD, cortisol levels are suppressed throughout the circadian cycle, but then show unusually robust responses to stress. However, individuals with ADHD show a great deal of variation, and unusual patterns of cortisol release seem more related to co-occurring conditions rather than to ADHD itself. While prolonged, elevated cortisol release can have damaging effects on the hippocampus, amygdala, and immune functions, evidence does not support the existence of “adrenal fatigue” in which the adrenal gland “burns out” and fails to make enough cortisol.

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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

03/04/2026

Cortisol is the major stress hormone of the body, pumped out by the adrenal gland, along with norepinephrine and epinephrine in response to stress. Cortisol affects energy availability, immune function, and mood and behavior. The adrenals also release cortisol with a daily rhythm. Prolonged, elevated cortisol release can harm the brain, immune system, and energy levels. But evidence does not support the existence of “adrenal fatigue” - the adrenal gland is the perpetrator, not the victim, of chronic fatigue, pain, and mood disturbances.

Cortisol from the adrenal glands helps us respond to stress and maintain energy, but despite many claims, adrenal glands don’t burn out.

03/02/2026

Weekly Q&A - 03 Mar 2026

Join me for my Weekly Q&A at:
https://youtube.com/live/AO3BQgitoCg

Livestream every Tuesday at 9:00am West Coast USA / 12:00pm East Coast USA / 7:00am Hawaii / 6:00pm Central European
www.youtube.com/

Next week's time will maintain the mainland USA 9:00 am time, but European viewers will need to adjust for the onset of US daylight savings time.

Video released this week:

- White Noise / Brown Noise and ADHD
https://youtu.be/OeUJcUaVXX0

After a short recap of each video, I’ll be available for questions on these topics or any other related to Mental Health.

- White Noise / Brown Noise and ADHD:

A small amount of research, almost all from one Scandinavian research team, suggests that white noise may help those with ADHD focus better. White and brown noise (similar to white noise but with an emphasis on lower, bass tones) have been more widely promoted on the internet as aids for sleep, relaxation, and improved concentration and energy. But some research on neuroplasticity indicates that there may be risks and potential damage associated with listening to white noise for hours at a time for prolonged intervals. Sounds from nature problem provide an equally soothing and less toxic soundscreen.

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You can also discuss and ask questions on my Reddit page:
https://www.reddit.com/r/Drjohnkruse

If you have ideas for additional talks, or other feedback, let me know:
drjohnkruse@gmail.com

My Medium page with hundreds of articles on Mental Health and other subjects:
https://dockruse.medium.com
Access to full articles requires paid membership.

Read writing from John Kruse MD, PhD on Medium. Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ free ADHD & mental health videos at: https://www.youtube.com/

03/01/2026

We fill our heads with stories about why other people act the way they do, and about our own intentions. But so often those narratives aren't accurate, and contribute to poor communicate and great distress. By understanding why intentions are so hard to assess, we can learn to deal with uncertainty around them.

https://medium.com/wise-well/were-often-wrong-in-assessing-intention-b033c470a485

Free link if you're not a member of Medium:
https://medium.com/wise-well/were-often-wrong-in-assessing-intention-b033c470a485?sk=33d63abcda393c8e7b9c3922ec4942bb

Humans are too quick to judge and to think they know what others are up to, but there are ways to correct for this.