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High doses of ADHD drugs linked to a greater risk of psychosis

3.3 million children, or 5 out of every 100 children in the U.S., are currently prescribed medication for ADHD. According to one estimate, nearly 30% of them are prescribed doses that might increase their risk ...

NBC NEWS – Taking a high dose of ADHD drugs is linked to more than five times greater risk of developing psychosis or mania, according to a new study published Thursday in the American Journal of Psychiatry.

The research is among the first to find a relationship between escalating doses of the drugs — amphetamines, in particular — and a greater likelihood of psychotic symptoms.

The drugs include Adderall, Vyvanse and generic amphetamines, such as dextroamphetamine.

The link between amphetamines and psychosis isn’t new. Amphetamines increase levels of dopamine in the brain. The neurotransmitter plays a number of roles in the body, including in memory, motivation and mood, but it’s also implicated in psychosis.

The drugs “can flood the brain with dopamine, and when you flood the brain with dopamine you potentially can cause psychosis,” said Dr. Jacob Ballon, a psychiatrist and co-director of the INSPIRE Clinic at Stanford Medicine, a clinic specializing in patients with psychosis.

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“We’ve seen this a lot. We are seeing college students coming in being prescribed stimulants who didn’t have much of a psychiatric history developing new onset psychosis.”

What hadn’t been established was that the risk of psychosis rose with higher doses, a phenomenon known as a “dose-response relationship.”

“That’s what this study provides,” said Dr. Will Cronenwett, vice chair for clinical affairs in psychiatry at Northwestern Medicine.

“The United States is having sort of an amphetamine moment right now,” Cronenwett said. “The popularity and use of amphetamines is high and getting higher.”

Stimulant use in the U.S. has skyrocketed in recent years, particularly among adults.

A study published this year in JAMA Psychiatry found that prescription rates for amphetamines for attention-deficit hyperactivity disorder had risen 30% from 2018 to 2022 in people ages 20 to 39. Among people ages 40 to 59, rates rose 17% …

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Teva Pharmaceuticals, the maker of Adderall, didn’t respond to a request for comment.

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