Attention-deficit/hyperactivity disorder medications are intended to help children with ADHD focus, but stimulants such as Adderall could cause psychological delusions, hallucinations, and psychosis, according to a new study out of Harvard University. Researchers found that people are significantly more likely to experience psychotic episodes when taking Adderall than drugs like Ritalin, which could have crucial implications for families considering their treatment options.
“We looked at new users, people who are being prescribed these medications for the first time,” study coauthor Lauren Moran, a psychiatrist at Harvard’s McLean Hospital, told CBS News. “We found that the Adderall-type drugs had an increased risk of psychosis.”
The reason for this difference likely boils down to how each drug functions. Both drugs have the job of getting dopamine, a neurotransmitter responsible for rewards and motivation, out of brain cells. But Ritalin blocks dopamine from being reabsorbed by neurons, while Adderall and other amphetamine-based medications cause the brain to release dopamine. Dopamine release, rather than blockage, is the same sort of thing that occurs naturally in patients with psychotic disorders.
“The patterns that we see with amphetamines more closely parallel what the studies of people with psychosis show,” she explained to Inverse. “And so that led me to think, maybe the Adderall-like drugs are more likely to cause psychosis than the Ritalin-like drugs.”
To learn more about potential psychiatric risks, Moran and her colleagues analyzed the insurance records of 221,846 people diagnosed with ADHD between age 13 and 25 who were prescribed methylphenidate (Ritalin) or amphetamine (Adderall) medications. Results revealed that one in every 486 patients experienced psychotic episodes after taking Adderall, compared to one in every 1,146 patients who endured psychosis after taking Ritalin. The findings are particularly concerning because the number of children taking Adderall has increased by 500 percent since 1990. The number of women in their reproductive primes taking ADHD medications is also on the rise, which could have implications for the mental health of expecting mothers, too.
“The rates of amphetamine use, particularly in this age group, is going up dramatically,” Moran said. “I guess that’s what’s kind of concerning, even though it’s a rare side effect.”
Indeed, it is important to note that psychotic episodes were a relatively infrequent overall, even when people took Adderall, and the study only looked at young people who were new to medications. Researchers also did not look at the effects on children under the age of 13, which may warrant further study. As a result, the findings may be more applicable to adolescents and young adults who are weighing the pros and cons of Ritalin versus Adderall, especially if they’re at a greater higher risk for a psychotic disorder because of family history, recreational drug use, or other variables. But people who’ve been taking it for some time and parents with children who have effectively treated their ADHD with Adderall don’t have to worry.
“Most of the psychotic episodes happened in the first several months of treatment,” Moran added. “So I think if you have a child who’s taking Adderall or Vyvanse and they’ve been taking it as prescribed and they’re benefitting from it, there’s no reason to take them off. This is really something that people should be considering when they’re first starting.”