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High doses of some ADHD medications are linked to psychosis

September 12, 2024 – People taking some ADHD medications like Adderall could also be at increased risk of significant psychiatric problems equivalent to psychosis or mania, especially in the event that they take higher doses.

ADHD medications work by increasing levels of brain chemicals called neurotransmitters, which help improve attention span, reduce hyperactivity, and manage impulsive behavior or problems with mental tasks equivalent to planning and organization. Although these medications are effective for a lot of, doctors and patients should pay attention to the possible mental health negative effects, especially when the dosage is high.

“Stimulants do not have an upper dose limit on their labels and dose is a factor in psychosis risk and should be a primary concern when prescribing stimulants,” said Lauren Moran, MD, a researcher who studies medication advantages, advantages and risks of medication in large population groups.

Moran's team at McLean Hospital in Belmont, MA, conducted research taking a look at emergency room visits and located that patients who were prescribed amphetamines like Adderall had a better risk of developing mania or mania inside a month of taking the drug to suffer psychoses. The results were published on Thursday The American Journal of Psychiatry.

psychosis refers to symptoms that mean an individual has lost touch with reality. These can include distrust and paranoid ideas, social withdrawal and more time alone, a decline in self-care or hygiene, difficulty distinguishing between reality and fantasy, and confused speech. individuals with mania You have exaggerated energy levels and a drastic change in mood or behavior, with symptoms equivalent to feeling invincible, little sleep, racing thoughts, rapid speech, and false beliefs or perceptions.

The evaluation included 1,374 people hospitalized for mania or psychosis and a pair of,748 people hospitalized for other mental illnesses, mostly depression, anxiety or each. The hospitalizations took place between 2005 and 2019 and the people were between 16 and 35 years old. This age range was chosen since it is typical for the onset of psychosis or schizophrenia. The researchers were capable of control for other potential influences equivalent to substance use, they reported.

Psychiatric patients recently prescribed amphetamine were greater than twice as prone to be diagnosed with psychosis or mania as those that didn’t use amphetamine. In individuals who took a high dose, the danger was increased by greater than five times.

The link between psychosis or mania and amphetamines has been established by previous research, but this latest study provides recent details about how dosage may affect risk.

According to the researchers, the best risk was present in individuals who took 30 milligrams or more of dextroamphetamine (comparable to 40 milligrams of Adderall).

There are two forms of stimulants commonly prescribed for ADHD: amphetamine medications and methylphenidate medications. Specifically, researchers found that there was no increased risk of psychosis or mania with prescribed methylphenidate medications (sold under many brand names, including Ritalin and Concerta). The increased risks were limited to stimulants like Adderall and Vyvanse.

The researchers cautioned that their study had limitations, including that their data only included hospitalized people and thus excluded those with less severe mental illnesses. Nevertheless, they concluded that “the study results suggest that caution should be exercised when prescribing high doses of amphetamines and should be regularly monitored for symptoms of psychosis or mania.”