JAMA psychiatry

Psychosis and Bipolar Disorder in People with ADHD Taking Stimulant Medication: A Summary and Analysis

Updated

Abstract

2.76% of individuals with ADHD prescribed stimulants developed psychotic symptoms.

  • Among individuals with ADHD, 2.29% developed a psychotic disorder and 3.72% developed bipolar disorder.
  • The risk of developing psychosis was significantly higher in individuals exposed to amphetamines compared to those treated with methylphenidate.
  • Increased occurrences of psychotic symptoms were associated with a higher proportion of female participants and smaller sample sizes.
  • Longer follow-up periods and studies conducted in North America showed a significantly higher prevalence of psychotic symptoms.
  • The findings indicate a nonnegligible occurrence of psychotic symptoms, psychotic disorders, or bipolar disorder associated with stimulant treatment in ADHD.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Salazar de Pablo reported personal fees from Janssen Cilag and Lundbeck outside the submitted work. Dr Aymerich reported personal fees from Janssen and Rovi outside the submitted work. Dr Chart-Pascual reported grants from Alicia Koplowitz Foundation outside the submitted work. Dr Solmi reported honoraria for advisory board service or presentations from AbbVie, Angelini, Lundbeck, and Otsuka outside the submitted work. Dr Catalan reported personal fees from Johnson & Johnson, Rovi, and Lundbeck outside the submitted work. Dr Corbeil reported grants from Canadian Institutes of Health Research outside the submitted work. Dr Shaw reported employment at King’s College London during the conduct of the study. Prof Fusar-Poli reported personal fees from Lundbeck, Angelini, Menarini, Sunovion, Boehringer, Proxymm, Science, Otsuka, Gedeon, and Richter outside the submitted work. Prof Cortese reported personal fees from the British Association of Psychopharmacology, Association for Child and Adolescent Mental Health, MEDICE, and National Institute for Health and Care Research and grants from the European Research Agency outside the submitted work. No other disclosures were reported.
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