ADHD patients on amphetamines like Adderall might at greater risk of psychosis, research finds

Researchers examined more than 200,000 young ADHD patients, an equal amount prescribed either amphetamines or methylphenidates. (Source: Pexels)
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(Gray News) - A study has found that young people with ADHD who take amphetamines such as Adderall may be as much as twice as likely to be affected by psychosis as those taking methylphenidates such as Ritalin.

The study, “Psychosis with Methylphenidate or Amphetamine in Patients with ADHD,” will be published on Thursday in the New England Journal of Medicine.

Researchers examined more than 200,000 young ADHD patients, an equal amount prescribed either amphetamines or methylphenidates.

While the overall risk for psychosis was still very low, more than twice the amount of patients in the amphetamine group (0.21 percent) were affected by it, compared to .10 percent of those in the methylphenidate group.

According to the National Institute of Mental Health, psychosis is a general description of “conditions that affect the mind, where there has been some loss of contact with reality.” It is not itself a mental illness, rather what the National Alliance on Mental Illness describes as a “disruption to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t.”

“The findings are concerning because the use of amphetamines in adolescents and young adults has more than tripled in recent years,” Dr. Lauren Moran, the study’s lead author, said in a release. “There is not a lot of research comparing the safety profiles of amphetamines and methylphenidate, despite increasing use of these medications.”

In an article accompanying the study in the New England Journal of Medicine, Dr. Samuele Cortese writes that while much of the world prescribes methylphenidates, “data from private insurance claims show that amphetamines are more commonly prescribed in the United States.”

Cortese notes that other analyses have found a “more favorable safety profile for methylphenidate than for amphetamine in young patients.”

Moran noted that it is not uncommon for patients with no previous psychiatric history to experience psychosis “in the setting of stimulant use.” Stimulant is the general term for ADHD medications like Adderall and Ritalin.

Cortese does caution that the study “cannot establish causality” and that data might be skewed, for example, by the possibility that some patients are simply more likely to experience psychosis with any kind of stimulant ADHD medication.

According to its release, the study examined insurance claims of patients aged 13-25 between Jan. 2004 and Sept. 2015 and how many of those patients on ADHD medication “developed psychosis that required treatment with antipsychotic medication.”

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