HQ Team
September 14, 2024: High doses of Attention Deficit and Hyperactivity Disorder (ADHD) medicines can lead to a greater risk of developing psychosis or mania, according to a new study.
ADHD medications
ADHD medications work on brain chemicals called neurotransmitters. These chemicals help people suffering from attention deficit to focus and curb impulsive behaviour. There are two types of stimulant medications prescribed for ADHD: amphetamine medications and methylphenidate medications. The researchers noted that people prescribed the methylphenidate medications (sold under numerous brand names, including Ritalin and Concerta) were not linked to a heightened risk of psychosis or mania. The increased risks were limited to stimulants like Adderall and Vyvanse.
Taking 30 milligrams or more of amphetamines (the equivalent of 40 milligrams of Adderall) can be risky.
“Stimulant medications don’t have an upper dose limit on their labels, and dose is a factor in psychosis risk and should be a chief consideration when prescribing stimulants,” said Lauren Moran, MD, author of the study
Higher dose
The research team at McLean Hospital in Belmont, MA looked at emergency room admissions and found that patients prescribed amphetamines had higher odds of having mania or psychosis within a month of using the medication.
The team observed 4,122 patients aged 16 to 35, hospitalized between 2005 and 2019 for various mental health issues. The researchers controlled substance abuse potential.
The study found that patients who were prescribed amphetamines recently were twice likely to be diagnosed with psychosis or mania and those with a high-dose prescription were five times at risk.
“Stimulant medications don’t have an upper dose limit on their labels, and dose is a factor in psychosis risk and should be a chief consideration when prescribing stimulants,” cautioned Lauren Moran, MD, author of the study.
Attention Deficit and Hyperactivity Disorder is one of the most common neurodevelopmental disorders of childhood, affecting approximately 10% of children, according to an FDA statement.
Stimulant use has increased in recent years among young adults. A study published in JAMA Psychiatry found that prescription rates for amphetamines for ADHD had risen 30% from 2018 to 2022.
Takeda Pharmaceuticals manufactures the Vyvanse brand, and in a statement to a news site the company said, “Takeda believes it is important for patients to take our medicines in accordance with U.S. Food and Drug Administration (FDA)-approved labelling guidance and in consultation with their prescribing health care provider.”
Teva Pharmaceuticals, the maker of Adderall, have yet to react to this study.
The study was published in the American Journal of Psychiatry.
