High Doses of Adderall Linked With Heightened Risk of Psychosis and Mania

A new study has found a connection between Adderall, the attention deficit hyperactivity disorder ( ADHD ) medication, and risks of psychosis and mania if ingested in high doses.

Knewz.com has learned that one of the key contributing factors behind the increasing risks of the aforementioned conditions is the increase in the number of young adults taking ADHD medication .

According to the data published by IQVIA, an industry data provider, in 2023, the number of prescriptions for stimulants and amphetamines has been on a steady rise since 2012.

The IQVIA report showed that in the United States alone, the numbers reached approximately 79 million in 2022.

Psychiatrist Dr. Lauren Moran, a research associate in the division of psychotic disorders at McLean Hospital in Massachusetts who led the recent study, stated that the team saw a large number of people “developing the first episode of psychosis or mania” after using prescription stimulants like Adderall.

It has been reported that psychosis and mania are known side effects of stimulant medications like prescription amphetamines.

The Food and Drug Administration (FDA) has also reportedly added labels that mention that medicines like Adderall can cause symptoms like “hallucinations, delusional thinking, or mania.”

It is worth noting that the percentage of people taking these medications and experiencing the side effects has usually been very low—reports mention that the symptoms kick in for every one in 1,000 patients.

The latest study conducted by the team led by Dr. Moran has established that the dosage of prescription amphetamines might be the factor that brings out the side effects.

The research found that patients who have been taking high doses of medicines like Adderall and Vyvanse are at a “fivefold increased risk of developing psychosis or mania for the first time compared with those who weren’t taking stimulants,” according to reports.

The study set the bar for high dosages at over 40 milligrams for Adderall, 100 milligrams for Vyvanse, or 30 milligrams of dextroamphetamine.

As part of the research, Dr. Moran and her team reviewed the health records of people aged 16 to 35 – which, according to reports, is the typical age range for the onset of psychosis – admitted at Mass General Brigham hospitals between 2005 and 2019.

“The researchers identified 1,374 individuals experiencing their first episode of psychosis or mania — a disruptive state characterized by high energy, erratic behavior — and compared them to 2,748 control patients who were hospitalized for other psychiatric conditions,” it was reported .

“They found those who had taken Adderall were 2.68 times more likely to have been hospitalized with psychosis or mania compared to those who were not — and this increased to 5.28 times more likely at higher doses of 40 milligrams and above.”

This means that around 81% of the psychosis or mania cases could have been prevented if not for the high Adderall dosage.

The research further found that those over 25 years of age were at a higher risk of psychosis or mania, although they were given a higher Adderall dosage as compared to the younger patients.

However, it was reported that it is unclear why some people who take stimulants might be at a higher risk of developing psychosis than others.

It was also pointed out that the “patients who experienced psychosis and mania were more likely to have a family history of bipolar disorder or psychosis, to use cannabis daily or to take stimulants that had not been prescribed.”

The study also analyzed the effects of Ritalin, which is another drug prescribed for ADHD, and found that this medicine posed no increased risks of the aforementioned conditions.

The paper based on the research done by Dr. Moran and her team was published in The American Journal of Psychiatry on September 12, and it mentioned that “caution should be exercised when prescribing high doses of amphetamines, with regular screening for symptoms of psychosis or mania.”

Dr. Max Wiznitzer, an ADHD expert and pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland , was quoted as saying, “I have patients on 60-milligram Adderall tablets or extended release daily with no problems.”

While more research is needed to properly understand the risk factors for psychosis and mania while on prescribed stimulants, Dr. Wiznitzer added that “it appears that the amphetamine product may have triggered an underlying predisposition.”