High doses of ADHD medication linked to increased risk of psychosis

Taking a high dose of ADHD medication increases the risk of developing psychosis or mania by five times, according to new research . While the link between ADHD meds and the risk for psychosis is not new, the direct link between dosage and the likelihood of developing psychosis is.

ADHD medications are amphetamines, which increase the levels of dopamine in the brain. Dopamine helps with things like motivation and mood, and has long been linked to the potential to increase psychotic symptoms .

The discovery comes as more and more Americans are taking this kind of medication. A separate recent study found prescription rates for amphetamines to treat ADHD went up 30% from 2018 to 2022 just among people between 20 and 39 years old; it went up 17% for those 40 to 49 years old.

So, what exactly is considered a “high dosage” of this kind of medication? That depends on the specific medication.

Harvard researchers looked at Adderall, Vyvanse, and the generic medication dextroamphetamine.

For Adderall , a medium dose is 20 to 40 milligrams while a high dose is anything over 40. For Vyvanse , medium would be 50 to 100 milligrams and high would be more than 100, and generic ’s medium dosage is 15 to 30 milligrams – so high is anything above 30.

Researchers linked the medium dosages to a 3.5 times higher risk of developing psychosis.

They also looked at another popular ADHD medication: Ritalin . Ritalin is not an amphetamine, and researchers found no increased risk associated with it.

Based on national insurance claim data , about 6% of people prescribed amphetamines for ADHD are on the highest dose, while 17% were prescribed medium doses.

The study’s authors also point out that even though these drugs significantly increase the risk of psychosis, the odds of it actually happening are still about 1 in 1,000.

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