Study finds ADHD treatment could increase risk of psychosis in youth

A team of researchers has found that certain medications prescribed to treat attention deficit hyperactivity disorder (ADHD) could induce psychosis among adolescents. The study evaluated common drug treatments like amphetamines and methylphenidates.

In the study, researchers determined that, although the risk of psychosis was low, it might increase, however, among those prescribed amphetamines, like Adderall and Vyvanse, compared to methylphenidates, like Ritalin or Concerta.

As part of a big data study, researchers probed 221,846 patients with ADHD, aged 13 to 25, who were prescribed either amphetamines or methylphenidates, between 2004 to 2015.

According to the findings, one out of every 486 patients who were prescribed an amphetamine exhibited symptoms of psychosis compared to the one in 1,046 patients on methylphenidate. Researchers note, however, that the increased risk of psychosis from the study was limited to youth who’d been recently diagnosed with ADHD and had just begun treatment.

“Among adolescents and young adults with ADHD who were receiving prescription stimulants, new-onset psychosis occurred in approximately 1 in 660 patients. Amphetamine use was associated with a greater risk of psychosis than methylphenidate,” the findings read.

“People who have been on a drug like Adderall for a long time who are taking the drug as prescribed and are tolerating it well are not likely to experience this problem,” said Lauren V. Moran, M.D., the study’s lead author.

“The findings are concerning because the use of amphetamines in adolescents and young adults has more than tripled in recent years. More and more patients are being treated with these medications. There is not a lot of research comparing the safety profiles of amphetamines and methylphenidate, despite increasing use of these medications.”

“The study illustrates the importance of using data from the real world, from diverse patients, to better understand the safety of commonly prescribed medications and allow physicians to weigh benefits and risks.”

The study was published in the New England Journal of Medicine.