Commonly used prescription drug taken by tens of millions causes five-fold increase in mental breakdown
Research shows that people who use Adderall are at a much higher risk of experiencing a mental breakdown.
People who had a prescription for ADHD medications or other stimulants were more than 60 percent more likely to develop psychosis or mania than people who did not take the medications.
Higher doses increased the risk even further: people taking the maximum FDA-recommended dose had a five-fold increased risk.
Study author Lauren Moran, a researcher at Mass General Brigham, said: ‘Our results clearly show that dosage is a factor in the risk of psychosis and should be an important consideration when prescribing stimulants.’
Adderall prescriptions have been steadily increasing over the past 12 years. The figures include prescriptions for both Adderall, brand and generic, in the U.S.
Figures show that one in eight Americans uses Adderall or other stimulants to treat attention deficit hyperactivity disorder (ADHD).
The drugs are intended to improve concentration and focus by: stimulate the nervous system, increase heart rate and alertness, and resemble the illegal drug ‘speed’.
Last year, 41 million prescriptions for Adderall were filled
They increase dopamine levels in the brain, which has been linked to hallucinations, delusions and paranoia.
The new study examined about 4,000 people between the ages of 16 and 35.
All patients were admitted to McLean Hospital after referrals from other hospitals in the Mass General Brigham health system.
The researchers identified 1,374 cases of individuals with a first-episode psychosis or mania, compared with 2,748 control patients who had been admitted to a psychiatric institution for other conditions, such as depression or anxiety.
They conducted a comparative analysis of stimulant use in the previous month, taking into account other factors, including substance use, to isolate the effects of stimulants.
They found that the risk was nearly 63 percent in people exposed to prescription amphetamine, and 81 percent in people exposed to high doses of amphetamine (equivalent to 40 mg of Adderall).
These findings suggest that in people who use prescription amphetamine, eight in 10 cases of psychosis or mania could have been prevented if they had not taken the high doses, the researchers said.
While a significant dose-related increase in risk was observed in patients taking high doses of amphetamine, no significant increase in risk was observed with the use of methylphenidate (Ritalin), which is consistent with previous research,
While Adderall is the most commonly used medication for ADHD in the U.S., there are several other approved medications, including methylphenidate (Ritalin), lisdexamfetamine (Vyvanse), and dexamfetamine (Dexedrine).
Although they all have a similar effect, they work on the brain in a slightly different way and contain different ingredients.
Moran said the findings should not be cause for concern, but they should lead to extra caution when prescribing these drugs, especially in people at increased risk of psychosis and mania.
“There is limited evidence that prescription amphetamines are more effective in high doses,” Moran said.
The findings were published in the American Journal of Psychiatry.
“Physicians should consider other medications that our research has shown to be less risky, especially if a patient is at high risk for psychosis or mania.”
In March 2020, as the virus emerged in the U.S., the federal government relaxed rules around prescribing ADHD medications, allowing telemedicine companies to prescribe the drug online, without the need for an in-person consultation.
The aim was to keep people out of hospitals and doctors’ offices, but still ensure access to medicines.
But this inadvertently created a thriving market for start-ups that shamelessly advertised their “60-second reviews” and aggressively marketed the drug via social media.
Today, about 41 million Americans have a prescription for Adderall, according to estimates, a 16 percent increase from before Covid struck. Four million new patients were given prescriptions last year, double the number the year before.
Millions of these patients are children and young adults. It is estimated that 10 percent of schoolchildren use the drugs, and a third of college students.
The FDA recommends that doctors prescribe no more than 40 mg of Adderall and other stimulants to ADHD patients. However, there is no upper dosage limit listed on the medications’ labels.