24-Hour Crisis Hotline: (877)SAFEGBC or (877)723-3422 Mental Health & Substance Abuse Issues

6502 Nursery Drive, Suite 100
Victoria, TX 77904
Fax: (361)578-5500

Childhood Mental Disorders and Illnesses
Basic Information
Introduction to Disorders of ChildhoodIntellectual DisabilitiesMotor Skills DisordersLearning DisordersCommunication DisordersAutism and Pervasive Developmental DisordersADHD and Disruptive Behavior DisordersFeeding and Elimination DisordersAnxiety DisordersReactive Attachment DisorderStereotypic Movement DisorderTic DisordersInfancy, Childhood or Adolescence, Not Otherwise Specified
Latest News
Largest-Ever Study Ties Over 100 Genes to AutismBrain Waves Offer Insight Into Autism-Linked Sleep StrugglesFamily Therapy Best for Youth at Risk for Bipolar Disorder1 in 4 Children With Autism Is Undiagnosed: StudyCould Brain Scans Spot Children's Mood, Attention Problems Early?Updated Autism Guidelines Stress Earliest Screenings PossibleBullying's 'Vicious Circle' Harms Mental HealthCould Fish Oil Be an ADHD Remedy for Some Kids?Most Parents Struggle to Spot Depression in TeensAcetaminophen in Pregnancy Might Raise Children's Odds of ADHD, AutismNew Finding Challenges Old Notions About DyslexiaRaising a Child With ADHD Can Test a ParentFor Kids With Asthma, Depression Makes ER Visit More LikelyPediatric Group Issues Updated ADHD GuidelinesU.S. Autism Rates Rising Fastest for Hispanics, BlacksBack-to-School Tips for Kids on the Autism SpectrumHealth Tip: Mental Illness Warning SignsScientists Uncover More Autism GenesADHD Meds May Alter Boys' BrainsUnlocking Speech for Kids With AutismADHD Meds Help Keep Kids Out of TroubleAutism Largely Caused by Genetics, Not Environment: StudyShame Around Mental Illness May Be Fading, Survey ShowsDevelopmental Tests Might Spot Autism at Even Younger AgesTreatments Targeting Social Behavior Hormone Show Promise With Autism'Microbiome' May Be Key to Autism SymptomsAutism Diagnoses Reliable at 14 Months, Study FindsDoes Diet Affect a Child's ADHD?Kids Can Get 'Stuck' on Traumatic Event, Leading to PTSDKids With Autism 'In Tune' With Mom's Feelings: StudySmartphone App May Boost Social Skills in Kids With AutismHealth Tip: Understanding Tourette SyndromeRisk of Psychosis Varies With ADHD Meds, But Still Small: StudyCan Some Children Outgrow Autism?More U.S. Teens, Kids Seeking Mental Health Care in ERsBurden of Autism in Teens Weighs Heaviest on Minorities, PoorMental Health Woes Are Rising in Young Americans -- Is Social Media to Blame?Teen Pot Use Linked to Later Depression, Suicide AttemptsHalf of U.S. Kids With a Mental Health Disorder Don't Get TreatmentGuideline Changes Have Asperger's Community on EdgeHarmless Brain Abnormalities in Kids Pose Disclosure Dilemmas
Questions and AnswersLinks
Related Topics

Autism Spectrum Disorder
Child & Adolescent Development: Overview
Child Development & Parenting: Infants (0-2)
Child Development & Parenting: Early (3-7)

Risk of Psychosis Varies With ADHD Meds, But Still Small: Study

HealthDay News
by By Amy NortonHealthDay Reporter
Updated: Mar 20th 2019

new article illustration

WEDNESDAY, March 20, 2019 (HealthDay News) -- Stimulant drugs used to treat attention-deficit/hyperactivity disorder (ADHD) carry a small risk of a psychotic episode, but it appears to vary depending on which medication young people use, a new study finds.

Soon after receiving a stimulant prescription, about one in 660 teens and young adults developed psychotic symptoms, such as hallucinations and hearing voices, the researchers said.

But the risk was not equal among the different stimulants. Amphetamines, like Adderall and Vyvanse, seemed to carry a relatively greater risk than the methylphenidates Ritalin and Concerta.

"These events are rare," stressed lead researcher Dr. Lauren Moran, of McLean Hospital in Belmont, Mass., and Harvard Medical School in Boston.

But, she added, they raise concerns because amphetamine prescriptions to young people have more than tripled in recent years.

About 5 million Americans under age 25 receive prescriptions for the drugs. Symptoms of ADHD include inattention, hyperactivity and impulsivity, which can affect social relationships, academics and job performance.

It's long been known that some young people taking stimulants for ADHD develop psychotic symptoms. In 2007, the U.S. Food and Drug Administration mandated a warning be placed on the drugs.

According to Moran, the findings suggest that when prescribing stimulants -- particularly amphetamines -- doctors should screen young people for their risk of psychosis. That means asking about factors such as drug abuse or a family history of psychosis.

There are alternative treatments, such as non-stimulant medications and behavioral therapy, Moran pointed out.

The findings are based on insurance records for nearly 222,000 teenagers and young adults, aged 13 to 25, who received a new prescription for a stimulant to treat ADHD. Overall, one out of every 486 amphetamine patients developed a psychotic episode that required an antipsychotic medication. That compared with one in 1,046 patients on Ritalin-like stimulants.

The results do not actually prove that amphetamines, per se, caused the higher risk of psychosis, Moran said. But, she added, other factors were weighed -- including the patients' age and sex, the severity of their ADHD, and any diagnoses of other mental health conditions or substance abuse.

And young people on amphetamines were still at higher risk of psychosis than those on methylphenidates.

Moran said the two groups of stimulants work by different mechanisms -- with amphetamines triggering a more potent release of the brain chemical dopamine. That might help explain the higher psychosis risk.

Dr. Rahil Jummani is a child and adolescent psychiatrist at NYU Langone, in New York City. He stressed the rarity of psychosis with ADHD medications, and said that risk needs to be weighed against the benefits of treatment.

"The baseline risk of psychosis is very low," Jummani said, adding that, in some cases, psychotic episodes may not be related to the medication at all.

Jummani said that in his experience, parents are usually more concerned about issues like the impact of ADHD medication on kids' growth. (The evidence is mixed on that, he noted.)

"Once we start talking about medication options, we discuss all the risks and benefits," Jummani said. "That conversation has to happen."

The patients in this study were all newly diagnosed with ADHD. As for young people who've been on stimulants for a long time, Jummani said it's "very unlikely" the medications will feed any new psychotic symptoms.

Moran agreed. "I don't think parents should be taking their kids off of [amphetamines] because of this," she said. "Not if they've been using them for a long time and are doing well."

The U.S. National Institutes of Health funded the study. The report was published in the March 21 issue of the New England Journal of Medicine.

More information

The U.S. National Institute of Mental Health has more on treating ADHD.