Attention deficit hyperactive disorder (ADHD) is a frequently discussed condition. According to the National Institutes of Mental Health, 4.4 percent of adults in the United States live with the condition. A suite of medications treat this disorder, including stimulants like amphetamines, which increase levels of the neurotransmitter dopamine in the brain. But a new finding reveals a potential risk to taking high doses of these medications.
A new study published today in The American Journal of Psychiatry found that people who take high doses of prescription amphetamines like Adderall and Vyvanse are at a higher risk for psychosis or mania. These widely prescribed, as well as often misused, drugs now bring a new potential sort of harm if taken without care.
The team of researchers from McClean Hospital in Massachusetts analyzed electronic health records of over 4,100 patients between ages 16 and 35. Over 1,300 were hospitalized for incident psychosis or mania between 2005 and 2019, compared to over 2,700 patients hospitalized for other reasons like depression and anxiety. The team specified a high dose as greater than 30 milligrams of the compound dextroamphetamine, and linked this amount to more than a five-fold risk of psychosis or mania. However, 30 milligrams is typically the upper prescribed dosage limit.
But patients taking the highest dosages, which is typically more than 40 mg of Adderall, 100 mg of Vyvanse, or 30 mg of dextroamphetamine, were 5.3 times more likely to develop psychosis compared to patients who didn’t take stimulants. Medium dosages, like 20 mg to 40 mg of Adderall, 50 mg to 100 mg of Vyvanse or 15 mg to 30 mg of dextroamphetamine — had a 3.5-fold risk.
Lead author Lauren Moran, a psychiatrist and researcher at McLean Hospital, a teaching hospital that is a part of Mass General Brigham in Boston, said psychosis related to amphetamines isn’t new. “We’ve seen this a lot,” Moran told NBC News. “We are seeing college students coming in being prescribed stimulants who didn’t have much of a psychiatric history developing new onset psychosis.”
This means that taking more than is recommended puts users at higher risk, which is even more reason not to misuse it. However, it also means anyone taking amphetamines should exercise great care, as should those who prescribe them.
