Study Highlights Risk of Psychosis with High-Dose ADHD Medications

THURSDAY, Sept. 12, 2024 (HealthDay News) — The prescription of amphetamine stimulants, such as Adderall, for the treatment of ADHD has increased significantly in recent years, particularly during the pandemic. However, a new study reveals that high doses of these stimulants can increase the risk of psychosis or mania by more than fivefold.

Researchers reported on Sept. 12 in a study that patients have a 63% increased risk of experiencing psychosis or mania if they have taken any prescription amphetamine within the past month. Those on particularly high doses, over 30 milligrams of dextroamphetamine or the equivalent of 40 milligrams of Adderall, faced an 81% higher risk of a psychotic episode.

The study was conducted by researchers analyzing data from nearly 1,400 patients admitted to Mass General Brigham Hospital between 2005 and 2019 who experienced their first episode of psychosis or mania. These patients were compared against more than 2,700 individuals hospitalized for other psychiatric conditions like depression or anxiety.

Dr. Lauren Moran, a pharmacoepidemiology researcher at McLean Hospital in Belmont, Massachusetts, and lead investigator of the study, emphasized that with no upper dose limit on stimulant medication labels, dose management should be a chief consideration. This is due to the established link between amphetamines, which increase dopamine levels in the brain, and the risk of psychosis.

Moran advised people taking amphetamines for ADHD not to be alarmed but to consult their healthcare providers regarding the dosage. The study found no increased risk of psychosis with methylphenidate (Ritalin), suggesting alternatives for those at higher risk.

Dr. Jacob Ballon from Stanford Medicine noted the phenomenon of ‘dose-response relationship,’ where escalating doses lead to a higher likelihood of psychotic symptoms. Dr. Will Cronenwett from Northwestern Medicine also highlighted the growing use of amphetamines in the U.S. and the importance of carefully managing dosages.

Takeda Pharmaceuticals, maker of Vyvanse, stated the importance of following FDA-approved guidance for their medications, while Teva Pharmaceuticals, maker of Adderall, did not respond for comment.