Adderall is an effective treatment Attention-deficit hyperactivity disorder ( Attention-deficit hyperactivity disorder) But a surge in prescriptions in the United States over the past two decades has raised concerns among researchers about rare but serious side effects.
in Shocking New Research In a study published Thursday, a team led by Lauren Moran, a psychiatrist at the Brigham Massachusetts General Hospital in Boston, found that people who took large amounts of stimulants had more than five times the risk of developing depression. Psychosis or Mania.
The main factors are the lack of upper dose guidelines and COVID-19 PandemicThis is largely due to the rise of telehealth providers.
Moran told AFP her interest was sparked when she worked in the inpatient ward of a hospital treating students attending universities in the Boston metropolitan area.
“We were seeing a lot of patients coming in with little to no psychiatric history who developed their first episode of psychosis or mania while using prescription stimulants,” she said.
When the Food and Drug Administration became aware of these cases in the 2000s, it added a warning to the drug’s label, but relatively little research has been done to quantify the incidence of side effects or how they relate to dosage.
For their study, Moran and his colleagues looked at electronic medical records of people ages 16 to 35 who were admitted to Massachusetts General Brigham Hospital between 2005 and 2019 — the age at which psychosis, or a loss of reality, typically begins.
The researchers identified 1,374 people who had experienced a first episode of psychosis or mania (a disruptive state characterized by high energy, erratic behavior) and compared them with 2,748 control patients who had been hospitalized for other psychiatric disorders.
By analyzing Adderall use in the previous month and controlling for other variables such as drug use, they were able to determine the impact of stimulants specifically.
They discovered People who took Adderall were 2.68 times more likely to be hospitalized for psychosis or mania than those who did not take the drug, and those who took high doses of 40 milligrams or more were 5.28 times more likely to be hospitalized for psychosis or mania than those who did not take the drug.
In another analysis, No increased risk with Ritalinanother stimulant prescribed for ADHD. Moran suggested this could be due to important differences in how the two drugs work.
Telemedicine companies
Both drugs increase levels of dopamine, a chemical messenger involved in the brain’s reward system, motivation, and learning. But while Adderall, an amphetamine, increases dopamine release, Ritalin works by blocking dopamine reuptake.
For Moran, a key lesson was the need for clear upper dose limits on the label: Current labels recommend treating patients with 20 milligrams, but in practice doctors vary widely in how they write prescriptions.
This variability is due in part to more severe ADHD symptoms requiring higher doses of medication, but Moran also observes occasional “carelessness in dose prescribing” and, in other cases, patients “shopping around” for a doctor who will prescribe the medication they want.
“People, including clinicians, may think they can eliminate all ADHD symptoms, but that’s not a realistic expectation,” she added.
Telemedicine companies in particular have come under scrutiny for overprescribing Adderall and contributing to shortages for people who really need the drug.
The Drug Enforcement Administration, which had proposed revoking telemedicine prescribing of Adderall, extended it until the end of 2024 after overwhelming public response.
©Agence France-Presse
