Lecture – Risk of Psychosis With Prescription Stimulants in Youths With ADHD

Available with English captions.

McLean Forum
Lauren V. Moran, MD, McLean Hospital

In This Presentation

The prescription use of stimulants methylphenidate and amphetamine (e.g., Ritalin and Adderall, respectively) 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 psychosis. Whether the risk of psychosis in patients with ADHD differs among various stimulants has not been studied.

In a recent study, Moran and colleague used data from two commercial insurance claims databases to assess patients 13 to 25 years of age who 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 for which an antipsychotic medication was prescribed. The study population consisted of 110,923 patients taking methylphenidate matched to 110,923 patients taking amphetamines. The rate of psychosis was greater in those prescribed amphetamines compared to methylphenidate.