Evidence map›Paper›PMID 41916954›Full record

ArticleTranslational psychiatry2026

Prescription psychostimulants, atomoxetine and the risk of psychosis in adults with history of psychosis: a population-based cohort study.

Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, Jeanette Westman

Abstract read
In one paragraph

Article in Translational psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Patrick BachDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. patrick.bach@ki.se.ORCID http://orcid.org/0000-0001-5962-019X
Johan FranckDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-4355-1967
Jonas HällgrenAcademic Primary Care Centre, Region Stockholm, Stockholm, Sweden.
Härje WidingAcademic Primary Care Centre, Region Stockholm, Stockholm, Sweden.
Mika GisslerAcademic Primary Care Centre, Region Stockholm, Stockholm, Sweden.
Jeanette WestmanAcademic Primary Care Centre, Region Stockholm, Stockholm, Sweden.

Funding

Karolinska Institutet (Karolinska Institute) 2020-02653
6 · The paper itself

Abstract

Concerns exist that psychostimulants may increase the risk of psychosis, particularly in individuals with a history of psychosis. This study assessed whether psychosis risk increases after initiating psychostimulant or atomoxetine treatment in individuals with prior psychotic events. In this cohort study, we used Swedish population-based register data that contain data on all Swedish residents. We identified adults aged 18-64, who had a history of psychosis and initiated psychostimulant or atomoxetine treatment between 2008 and 2021. A within-individual design compared the rate of psychotic events in two 6-month periods before and after treatment initiation. Rate ratios (RR) with 95% confidence intervals (CI) were estimated. Sensitivity analyses were stratified by sex, age groups, and medication classes and also investigated substance-related psychosis as alternative outcome. We identified 3,770 individuals with a history of psychosis that received psychostimulant or atomoxetine prescriptions during the study period. Compared to the period before treatment initiation, the RR for psychotic events in the six months following treatment initiation was 0.95 (95% CI 0.84-1.08). Sensitivity analyses, considering only substance-induced psychotic events, or eight-week intervals and subgroup analyses by sex, age groups and separately for individuals receiving either (dex-)methyphenidate or (lis-)dexamphetamine or atomoxetine or (ar-)modafinil showed consistent results. Contrary to concerns, psychostimulant or atomoxetine treatment was not associated with an increased risk of psychotic events in adults with a history of psychosis. These findings may inform clinicians considering psychostimulant prescriptions in this population.

Indexed as

Atomoxetine HydrochlorideCentral Nervous System StimulantsPsychoses, Substance-InducedPsychotic DisordersAdolescentAdrenergic Uptake InhibitorsAdultCohort StudiesFemaleHumansMaleMiddle AgedRegistriesSwedenYoung AdultAdrenergic Uptake InhibitorsAtomoxetine HydrochlorideCentral Nervous System Stimulants

Identifiers

PMID41916954
PMCPMC13043684

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.