ArticleBMJ mental health2024
Psychosis with use of amphetamine drugs, methylphenidate and atomoxetine in adolescent and adults.
Article in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Occurrence of Psychosis and Bipolar Disorder in Individuals With Attention-Deficit/Hyperactivity Disorder Treated With Stimulants: A Systematic Review and Meta-Analysis.JAMA psychiatry · 2025Pooled it
- Attention deficit hyperactivity disorder: transition to psychotic disorders.Molecular psychiatry · 2026Review
- Case for caution in expanding attention deficit hyperactivity disorder prescribing.Internal medicine journal · 2026Review
- Prescription psychostimulants, atomoxetine and the risk of psychosis in adults with history of psychosis: a population-based cohort study.Translational psychiatry · 2026Article
- Unveiling Social Media Content Related to ADHD Treatment: Machine Learning Study Using X's Posts over 15 Years.Healthcare (Basel, Switzerland) · 2025Article
- Perioperative Stroke in MCA Aneurysm Surgery: The Hidden Risks of Amphetamine Use.Journal of clinical medicine · 2025Article
- Risk of hospitalisation for first-onset psychosis or mania within a year of ADHD medication initiation in adults with ADHD.BMJ mental health · 2025Article
- Advancing the evidence base for child and adolescent psychopharmacology.BMJ mental health · 2025Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUse of psychostimulants and relative drugs has increased worldwide in treatment of attention-deficit hyperactivity disorder (ADHD) in adolescents and adults. Recent studies suggest a potential association between use of psychostimulants and psychotic symptoms. The risk may not be the same between different psychostimulants.
objectiveTo assess whether amphetamine or atomoxetine use is associated with a higher risk of reporting symptoms of psychosis than methylphenidate use in adolescents and adults, particularly in patients with ADHD.
methodsUsing VigiBase, the WHO's pharmacovigilance database, disproportionality of psychotic symptoms reporting was assessed among adverse drug reactions related to methylphenidate, atomoxetine and amphetamines, from January 2004 to December 2018, in patients aged 13-25 years. The association between psychotic symptoms and psychostimulants was estimated through the calculation of reporting OR (ROR).
findingsAmong 13 863 reports with at least one drug of interest, we found 221 cases of psychosis with methylphenidate use, 115 with atomoxetine use and 169 with a prescription of an amphetamine drug. Compared with methylphenidate use, amphetamine use was associated with an increased risk of reporting psychotic symptoms (ROR 1.61 (95% CI 1.26 to 2.06)]. When we restricted the analysis to ADHD indication, we found a close estimate (ROR 1.94 (95% CI 1.43 to 2.64)). No association was found for atomoxetine.
conclusionOur study suggests that amphetamine use is associated with a higher reporting of psychotic symptoms, compared with methylphenidate use. CLINICAL IMPLICATIONS: The prescription of psychostimulants should consider this potential adverse effect when assessing the benefit-risk balance.
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Registered trials
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