A Massachusetts psychiatrist has a warning about common prescription ADHD medications, which she says may increase the risk of psychotic and manic episodes when taken in high doses.
Dr. Lauren Moran of McLean Hospital in Belmont, published a study with the risk findings on Thursday, which she said was sparked by her own observations while working as an inpatient psychiatrist at McLean.
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"We were seeing a lot of young college students without much of a psychiatric history, coming in with the first episode of psychosis or mania in the context of prescription stimulant use," Moran said. "So that's kind of why I started to decide to do research in this area, really to raise awareness of this problem."
Attention-deficit/hyperactivity disorder is commonly treated with prescribed amphetamines, such as Adderall. This type of drug can help people with ADHD to stay on task and focus.
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ADHD drug prescriptions have been rising over the past 10 years, with some of the sharpest increases happening over the COVID-19 pandemic, according to Mass. General Brigham, which McLean is associated with.
For most people, the medications work well, but Moran has concerns about high doses.
"There's a lot of research about the benefits of stimulants, but I think I'm trying to raise awareness about this rare but very serious side effect," Moran said.
Moran's study, published in the American Journal of Psychiatry, found that high doses of these drugs were associated with more than a five-fold increased risk of new-onset psychosis or mania.
The risk was found to be highest in people taking 30 mg or more of dextroamphetamine, which equates to 40mg of Adderall. Data from emergency intakes of Mass General Brigham patients was used to inform the study.
Moran believes that a warning label is needed telling the risks associated with high dosages, especially as ADHD diagnoses and amphetamine prescriptions become more common.
And although ADHD is a condition often associated with children, more adults have been seeking help, too.
"It's also people working from home, being on Zoom meetings," she said. "It's harder to pay attention, compared to like when you're in an office and talking to people and it's more dynamic. And so that could also be driving the increase in use that we're seeing."
She added that people need to have realistic expectations for themselves, especially in an age with so many things vying for our attention.
"The drugs aren't going to get rid of the fact that you have ADHD, it's just going to make it a little more manageable," she said.
Moran noted that some ADHD medications, such as Ritalin and Concerta, did not appear to increase the risk of these side effects in her study. Those drugs, while also stimulants, are not amphetamines.
In a statement to NBC News, a spokesperson for Takeda Pharmaceuticals, the maker of Vyvanse, said, "Takeda believes it is important for patients to take our medicines in accordance with U.S. Food and Drug Administration (FDA)-approved labeling guidance and in consultation with their prescribing health care provider."
Teva Pharmaceuticals, the maker of Adderall, didn’t respond to a request for comment.
