Recent research has found that taking a high dose of ADHD drugs could significantly increase your risk of developing psychosis or mania.
According to a new study published in the American Journal of Psychiatry, drugs like Adderall, Vyvanse, and generic amphetamines can lead to psychosis and mania in patients if not properly monitored. The ADHD and psychosis connection only seems to occur in high doses, defined as over 30 mg of dextroamphetamine or the equivalent.
One estimate found that nearly 30% of patients are prescribed high enough doses.
Prescription amphetamines “can flood the brain with dopamine, and when you flood the brain with dopamine you potentially can cause psychosis,” according to Jacob Ballon, a psychiatrist and co-director of the INSPIRE Clinic at Stanford Medicine.
Previous research has suggested similar findings, like a 2019 New England Journal of Medicine study that found that amphetamine use was associated with a higher risk of psychosis compared to methylphenidate in young people with ADHD.
The new study is unique because it sheds light on the “dose-response relationship,” where the risk of psychosis and mania rises with the higher dose.
“The United States is having sort of an amphetamine moment right now,” Will Cronenwett, vice chair for clinical affairs in psychiatry at Northwestern Medicine, told NBC News. “The popularity and use of amphetamines is high and getting higher.”
Unfortunately, patients using these drugs can develop symptoms of psychosis if they’re on a high dose.
“We’ve seen this a lot,” said Lauren Moran, lead study author. “We are seeing college students coming in being prescribed stimulants who didn’t have much of a psychiatric history developing new-onset psychosis.”
Still, the chance of developing psychosis from ADHD medications is relatively rare in the grand scheme of things, sitting at about 1 in 1,000 people, according to Cronenwett. However, it’s important to understand and monitor your risks with a professional—especially if they have a history of other mental illnesses.
“I would counsel patients who have a personal or family psychiatric history of serious mental illness, including things like bipolar disorder with mania or schizophrenia,” said Cronenwett. “If these sorts of illnesses are in the family tree, then that’s somebody who might want to be very careful about how much of these medicines they use and in what doses.”
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