ADHD medications do not influence episodes of psychosis

NEW YORK (HealthDay News)—Stimulant medications for ADHD do not increase children's risk of psychosis, according to a new study.

An analysis of stimulant prescriptions among nearly 8,400 children with attention-deficit/hyperactivity disorder found no evidence that the drugs caused psychosis, researchers reported in the journal Pediatrics.

“Previous observational research has suggested that stimulants may play a causal role in the development of psychotic experiences in young people with ADHD,” wrote the team led by lead researcher Ian Kelleher, a professor of child and adolescent psychiatry at the University of Edinburgh, UK.

But this perceived link is likely because children who are more likely to receive treatment for ADHD also share factors that put them at higher risk for psychotic episodes.

These factors include more severe ADHD symptoms and a greater number of other mental health problems. "Our findings do not support a causal relationship between stimulant prescription and psychotic experiences," the study concluded.

"Rather, the association appears to be confounded by factors that increase the likelihood of stimulant prescription and lead to psychotic experiences."

In the study, researchers followed the health of children participating in a study of adolescent brain development in the United States. The children, ages 9 to 10, were recruited between 2016 and 2018.

Of those children, just under 6 percent had been prescribed one or more stimulants.

Initial results indicated that stimulant medications increased the risk of a psychotic episode by 46%.

However, researchers found the opposite was also true, with psychotic episodes nearly doubling the odds of a child being prescribed stimulant medication.

After adjusting for this two-way association, the researchers found no significant link between ADHD medication use and psychosis.

“Our findings suggest that shared characteristics associated with psychotic experiences and the likelihood of receiving ADHD treatment may drive the association between stimulants and psychotic experiences, rather than stimulants playing a causal role,” the researchers concluded.

“Young people with more severe ADHD are likely to be more likely to develop psychotic experiences and are also more likely to be prescribed stimulants,” they added.