Hospitalized patients who took high doses of ADHD prescription amphetamines were five times likelier to develop psychosis and mania than patients not on the medication, a study found.
The study of more than 1,300 patients at Mass General Brigham hospitals linked their risk for psychosis and mania to the dosage of prescription stimulants a person took. These medications are used to help people concentrate at school or work. Patients who took 30 milligrams or more of dextroamphetamine − or 40 milligrams of Adderall − developed psychosis and mania nearly 5.3 times more often than those who did not take the medication, according to the study published Thursday in the American Journal of Psychiatry.
The study found no such link for another common ADHD medication methylphenidate, which is sold under the brand name Ritalin.
Earlier research has shown that psychosis and mania occurred in fewer than 1% of people who took these commonly used prescription amphetamines. But for the first time, the Mass General Brigham study shows a link between prescription strength and certain side effects.
Although the side effects of the drug are a rarity, study lead author Lauren Moran said doctors who prescribe these stimulants for attention-deficit/hyperactivity disorder should "maybe stay away from (higher) doses, or just make sure that you’re carefully monitoring patients."
Other researchers not involved in the study said it provides important information to doctors who prescribe stimulants such as Adderall.
Nina Kraguljac, a professor of psychiatry and behavioral health at Ohio State University, said the study clarifies that only higher doses of Adderall and other prescription amphetamines are linked to higher risk.
Kraguljac said the study shows doctors may not want to exceed 30 milligrams when prescribing dextroamphetamine or 40 milligrams for Adderall.
"That is absolutely novel, very clinically relevant and very helpful because it also assures you don’t necessarily increase your psychosis risk by taking lower to medium doses," Kraguljac said. Higher doses pose a greater risk Researchers carried out the study because doctors had noticed some patients with psychosis and mania also had taken prescription amphetamines, said Moran, a psychiatrist and a pharmacoepidemiology researcher at McLean Hospital, a psychiatric hospital […]
High doses of Adderall linked to this rare mental health risk: What to know.
