Stimulants are effective for the treatment of attention deficit–hyperactivity disorder (ADHD). (Funded by the National Institute of Mental Health and others.) Introduction
Amphetamine use was associated with a greater risk of psychosis than methylphenidate. ConclusionsĪmong adolescents and young adults with ADHD who were receiving prescription stimulants, new-onset psychosis occurred in approximately 1 in 660 patients. person-years): 106 episodes (0.10%) in the methylphenidate group and 237 episodes (0.21%) in the amphetamine group (hazard ratio with amphetamine use, 1.65 95% confidence interval, 1.31 to 2.09).
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There were 343 episodes of psychosis (with an episode defined as a new diagnosis code for psychosis and a prescription for an antipsychotic medication) in the matched populations (2. The study population consisted of 221,846 patients with 143,286 person-years of follow up 110,923 patients taking methylphenidate were matched with 110,923 patients taking amphetamines. We assessed 337,919 adolescents and young adults who received a prescription for a stimulant for ADHD. To estimate hazard ratios for psychosis, we used propensity scores to match patients who received methylphenidate with patients who received amphetamine in each database, compared the incidence of psychosis between the two stimulant groups, and then pooled the results across the two databases. The outcome was a new diagnosis of psychosis for which an antipsychotic medication was prescribed during the first 60 days after the date of the onset of psychosis. We used data from two commercial insurance claims databases to assess patients 13 to 25 years of age who had received a diagnosis of ADHD and who started taking methylphenidate or amphetamine between January 1, 2004, and September 30, 2015. Whether the risk of psychosis in adolescents and young adults with ADHD differs among various stimulants has not been extensively studied. In 2007, the Food and Drug Administration mandated changes to drug labels for stimulants on the basis of findings of new-onset psychosis. The prescription use of the stimulants methylphenidate and amphetamine for the treatment of attention deficit–hyperactivity disorder (ADHD) has been increasing. The most trusted, influential source of new medical knowledge and clinical best practices in the world.
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