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Ask the Pharmacist: Caffeine is a natural option for ADHD

Suzy Cohen
Columnist

Caffeine is the number one stimulant and and psychoactive drug in the world.

The category of ADHD medications such as Concerta, Adderall, Ritalin, Dexedrine and others are “stimulant” drugs, and so is caffeine. They all raise certain compounds in the body such as dopamine and norepinephrine (and others).

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Caffeine artwork

Here are five reasons why I think this is a good option for some of you:

  1. Most all medical treatments for ADHD include a nervous system stimulant, which may sound strange to you, considering the patient appears to be overly active, wound up or unfocused. But this is true, conventional treatment of ADHD utilizes physiological stimulants. Caffeine is a stimulant.
  2. A study published in the European Neuropsychopharmacology, concluded that caffeine can normalize dopamine levels (which is exactly what the pharmacy drugs do). Caffeine raises both dopamine and norephinephrine, just like the medications.
  3. There was a study that evaluated caffeinated tea. They concluded that “The caffeine in tea can reduce one’s fatigue, increase people’s self-confidence, motivation, alertness, vigilance, efficiency, concentration, and cognitive performance.”
  4. So profound is caffeine’s impact on the brain and cognitive function that Stanford University even funded a small study to evaluate if dextroamphetamine is superior to caffeine in Obsessive Compulsive Disorder (OCD). 
  5. Caffeine has been shown to extinguish the action of adenosine receptors in your brain. This was discussed in a 2014 review article published in the Journal of Psychopharmacology which recommended the use of caffeine for ADHD. 

Just like methylphenidate, caffeine begins to work in about an hour, and as you might expect, the effect wears off after about four hours. Both methylphenidate and caffeine are absorbed and physiologically processed in a similar way. Their mechanism of action is the same, as are the side effects. One is a prescription amphetamine drug, the other is America’s favorite hot coffee! 

Image source: Getty Images
Almost everyone needs their daily dose of caffeine. That means the world's most popular legal drug is a great business to be in. People buy a latte from  Starbucks   (NASDAQ: SBUX)  to get them going in the morning, then turn to a can of Diet  Coke   (NYSE: KO)  to survive the mid-day slump.
But for investors, the important question is: Which company's stock is a better buy today?
While there's no definitive answer to that question, we'll view responses through three different lenses.
Financial fortitude
Lots of people think cash is boring. If it's not being reinvested or distributed to shareholders, it's just sitting there, getting eaten away by inflation. But in a world where the future is unknowable, cash provides flexibility. If tough times hit, a company flush with cash can outspend rivals, buy back shares, or even make splashy acquisitions.
The opposite is true for those who are in debt. Cash-strapped companies usually need to narrow their focus in the face of a recession, and often cede market-share to competitors in an effort to stay afloat. Luckily for investors, both Starbucks and Coke have fairly robust balance sheets.



Company

Cash

Debt

Net Income

Free Cash Flow





Starbucks


$2.3 B


$3.6 B


$2.5 B


$2.6 B




Coke


$24.1 B


$48.4 B


$7.3 B


$7.0 B




Data source: Yahoo! Finance, SEC filings. Net Income and FCF are in trailing twelve month format.
It should be noted when viewing these figures that Coke is valued at roughly 2.3 times the size of Starbucks. Given that, I would argue that Starbucks has a slight edge in terms of financial fortitude. The company's debt load is more reasonable -- relative to cash on hand -- than Coke's.
But make no mistake: Coke is still doing just fine -- it produces more than enough free cash flow to meet its debt obligations.
Winner = Starbucks
Sustainable competitive advantages
In my eight years as an investor, no variable has been more important to the success of my investments than a company's  sustainable  competitive advantages. Both of these companies rely heavily on the strength of their brands.
Forbes  recently ranked Coke as the fourth most valuable brand in the world, valued at almost $60 billion. The company also owns several popular drinks outside of its namesake: Sprint, Fanta, PowerAde, Dasani water, Odwalla juices, Honest Tea, and Glaceau Smart Water... to name a few.
Starbucks, on the other hand, came in at 45 th , with a brand value of almost $12 billion. That's nothing to scoff at, though, as no other coffee house made the list. Starbucks also owns other brands, including Teavana, Seattle's Best, and Evolution Fresh.
At the end of the day, relative to the competition, each of these companies have the most powerful brands in their respective industries, landing them in a tie.
Winner = Tie
Valuation
While there's no one metric that can accurately capture valuation, there are several we can use to build a more complete picture. Here are four of my favorites.



Company

P/E

P/FCF

P/S

PEG Ratio





Starbucks


32


33


4.1


1.6




Coke


22


27


4.3


7.5




Data source: SEC filings, Yahoo! Finance, E*Trade. Non-GAAP EPS used to calculate P/E.
Make no mistake: both of these companies have expensive stocks. But Coke's PEG Ratio alone shows that it is considered  very  overvalued. Soda sales have been flagging in the United States for years, and I wouldn't be surprised to see the rest of the world follow suit in the decades to come. While Coke has other brands to help offset these losses, sugary carbonated water remains its best-seller.
The opposite is true for Starbucks: the world loves its caffeine, and while too much of it can be a bad thing, the health benefits between coffee and soda decidedly come down on coffee's side. Starbuck's brand, and its desire to create a "third place" make it an increasingly popular destination in Asia -- its key growth market.
That's why I think Starbucks deserves its rich valuation, and I'm more wary of Coke's.
Winner = Starbucks
A clear winner
As we all know, past results are not indicative of future performance. But over the last five years, shares of Starbucks have returned 215% compared to Coke's 50%. Given the factors discussed above, I wouldn't be surprised to see the same trend continue over the next five years.
Brian Stoffel  owns shares of Starbucks. The Motley Fool owns shares of and recommends Starbucks. The Motley Fool recommends Coca-Cola. Try any of our Foolish newsletter services  free for 30 days . We Fools may not all hold the same opinions, but we all believe that  considering a diverse range of insights  makes us better investors. The Motley Fool has a  disclosure policy .    The Motley Fool is a USA TODAY content partner offering financial news, analysis and commentary designed to help people take control of their financial lives. Its content is produced independently of USA TODAY.
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The downside is that caffeine can wear out adrenals if taken long-term. Caffeine content varies with each food and beverage making daily dosing through diet somewhat difficult. With tea, the amount of time that you steep the teabag determines the caffeine content. 

Some people find that caffeine helps their ADHD, while others find that it doesn’t offer any benefit at all. Pay attention to your body and work with your doctor/therapist to find out what is right for you. Too much caffeine or excessively high dosing on stimulants medications may cause insomnia, tachycardia, aggression, diarrhea and dehydration. 

The intake of caffeinated drinks, caffeine pills or energy drinks containing caffeine or guarana may seem like a nice and exciting alternative to prescription medications, I just want to caution you that if combined with conventional (amphetamine) medications, the impact could be dangerous. As an aside, many studies point to DHA Fish Oil as a useful essential fatty acid, which may be taken with medications or caffeine. 

Stock photo of coffee cup

How much caffeine is too much? The United States FDA hasn’t fully defined this but the Canadian government has suggested not to exceed 85 mg in kids aged 10 to 12 years. I have a much more comprehensive version of this article that I can email to you if you sign up for my free newsletter at suzycohen.com.

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit SuzyCohen.com.