What’s the link between ADHD medication and psychosis?
Stimulant medications are typically the first treatment option for attention-deficit hyperactivity disorder. As ADHD diagnoses have gone up, so have prescriptions.
A recent surge in reports has raised concerns that Australians are developing psychosis after using stimulant medications, typically prescribed for attention deficit hyperactivity disorder (ADHD). Psychosis is a mental health symptom involving difficulty separating reality from non-reality, causing hallucinations or distorted thoughts. While rare, psychosis can require immediate care. Given the rising number of Australians taking ADHD medication, the question arises: how concerned should we be?
Stimulant medications are the most common treatment for ADHD in Australia, including methylphenidate (Ritalin and Concerta) and amphetamine-based drugs like dexamfetamine and lisdexamfetamine (Vyvanse). Non-stimulant options are less prevalent. These drugs work by increasing dopamine and noradrenaline, neurotransmitters crucial for motivation, reward, and focus.
The number of people prescribed stimulants for ADHD has surged – from 2 in 1,000 in 2004-05 to 22 in 1,000 in 2023-24, or nearly 600,000 individuals. Stimulants are proven effective for ADHD, reducing impulsiveness, distractibility, and linked to lower risks of accidents, substance misuse, suicidal thoughts, and criminal convictions. However, there is a potential risk of psychosis when taking these medications, similar to other widely-used drugs like oral glucocorticoids.
The probability of developing psychosis from stimulants is low (0.2-3% of the population), lower than the prevalence of many psychotic disorders in the general population. A US study of over 220,000 teenagers and young adults who started stimulant medications found about one in 660 developed psychosis. Research combining 16 studies across 390,000 people with ADHD also showed a low overall risk: 2.8% of people prescribed stimulants developed psychotic symptoms.
However, this evidence does not imply a lasting disorder, and there is less evidence of a link to a serious psychotic issue. The risk of harm, including psychosis, may be higher when these medications are used without a prescription or illicitly, often involving high doses of methamphetamine or other stimulants administered through smoking or injection.
Written by urgent.news from The Conversation AU's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
