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Visual Abstract
Psychosis with Methylphenidate or Amphetamine in Patients with ADHD
Lauren V. Moran, M.D., Dost Ongur, M.D., Ph.D., John Hsu, M.D., M.S.C.E., Victor M. Castro, M.S., Roy H. Perlis, M.D., and Sebastian Schneeweiss, M.D., Sc.D.
Summarized by:
July 26, 2023
study source
NEJM
March, 2019
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What they studied
Does taking Ritalin or Adderall cause different rates of psychosis?
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What they found
Adderall was linked with a significantly higher risk of psychosis compared to Ritalin among teens and young adults.
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What this means
While it is a rare side-effect, these results do suggest that Adderall can potentially cause psychosis, more so than Ritalin.
Psychosis with Methylphenidate or Amphetamine in Patients with ADHD
Objectives
This study aimed to examine whether Adderall and Ritalin could potentially increase the risk of psychosis for those with ADHD.
Adderall and Ritalin are both stimulant medications used to treat ADHD. They are some of the most effective and commonly prescribed treatments.
There are some concerns that these medications may cause psychosis, as shown in the warning list above.
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In 2007...the Food and Drug Administration required manufacturers of stimulants to add a warning to drug labels that “stimulants may cause treatment-emergent psychotic or manic symptoms in patients with no prior history.”
This study aimed to calculate the risk of psychosis for Adderall and Ritalin among teens and young adults.
Study Quote
The prescription use of the stimulants methylphenidate and amphetamine for the treatment of attention deficit–hyperactivity disorder (ADHD) has been increasing. In 2007, the Food and Drug Administration mandated changes to drug labels for stimulants on the basis of findings of new-onset ...
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Methods
The study collected data from 337,919 teens and young adults who were prescribed generic or brand-name Adderall and Ritalin. Researchers collected information on prescriptions and new psychosis diagnoses.
With this information, they were able to estimate rates of psychosis among those prescribed ADHD medication.
Study Quote
We used data from two commercial insurance claims databases to assess patients 13 to 25 years of age who had received a diagnosis of ADHD and who started taking methylphenidate or amphetamine between January 1, 2004, and September 30, 2015. The outcome was a new diagnosis of psychosis fo...
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Results
Overall, psychosis was rare. The vast majority of those taking Adderall and Ritalin did not experience psychosis:
However, there was some evidence that stimulant medications could increase the risk of psychosis. Those on Adderall were significantly more likely to develop psychosis than those on Ritalin:
The researchers estimated that Adderall was linked with a roughly 65% higher risk of psychosis compared to Ritalin:
Study Quote
We assessed 337,919 adolescents and young adults who received a prescription for a stimulant for ADHD. The study population consisted of 221,846 patients with 143,286 person-years of follow up; 110,923 patients taking methylphenidate were matched with 110,923 patients taking amphetamines...
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Conclusions
These results provide further evidence for thelink between ADHD medication and psychosis. Those on Adderall were more likely to develop psychosis than those on Ritalin.
Study Quote
We used data from two commercial insurance claims databases to assess patients 13 to 25 years of age who had received a diagnosis of ADHD and who started taking methylphenidate or amphetamine between January 1, 2004, and September 30, 2015. The outcome was a new diagnosis of psychosis fo...
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