Psychosis with methylphenidate or amphetamine in patients with ADHD

New research suggests that some adolescents and young adults with ADHD may have a higher risk for psychosis with certain drugs. The study involved 221,846 patients aged 13–25 years with 143,286 person-years of followup: 110,923 taking methylphenidate who were matched with an equal number taking amphetamines.

New research suggests that some adolescents and young adults with ADHD may have a higher risk for psychosis with certain drugs. The study involved 221,846 patients aged 13–25 years with 143,286 person-years of followup: 110,923 taking methylphenidate who were matched with an equal number taking amphetamines. The primary outcome was an ICD-9 or ICD-10 code for a new diagnosis of psychosis and a prescription claim for an antipsychotic medication on the same day as the initial diagnosis of psychosis or within 60 days of that diagnosis. According to the data, there were 343 episodes of psychosis in the matched populations, with 106 (0.10%) in the methylphenidate group and 237 episodes (0.21%) in the amphetamine group. The researchers conclude that "the risk of new-onset psychosis was approximately 1 in 660 patients who received a prescription for stimulants for ADHD, but the risk was about twice as high among patients who started amphetamine as among patients who started methylphenidate."