Adderall has become a staple for many young adults managing ADHD, especially since the rise of telemedicine during the pandemic made it easier than ever to get a prescription. But new research is shedding light on some serious, often overlooked side effects of the popular stimulant.
A study published in the American Journal of Psychiatry reveals that individuals taking high doses of Adderall are more than five times as likely to experience psychosis or mania. A current poll shows that 38% of people between the ages of 18 to 44 either personally have an Adderall prescription or know someone who does.
Dr. Lauren Moran, a psychiatrist at Mass General Brigham, led the study after noticing a troubling trend in her practice.
"We were seeing a lot of people coming in without much of a psychiatric history, developing the first episode of psychosis or mania in the context of using prescription stimulants," she said.
The study reviewed health records of 16 to 35-year-olds admitted to Mass General Brigham hospitals from 2005 to 2019, a prime age range for the onset of psychosis. Out of 1,374 individuals experiencing their first episode of psychosis or mania, those who had recently taken Adderall were 2.68 times more likely to be hospitalized for these conditions. At doses above 40 milligrams, the risk jumped to 5.28 times more likely.
Interestingly, the study found no similar risk increase with Ritalin, another common ADHD medication. This difference, Moran theorized, might stem from how the drugs interact with the brain's dopamine levels. While both medications affect dopamine -- a key player in motivation, reward and learning -- Adderall increases dopamine release, whereas Ritalin blocks its reabsorption.
One of the key issues flagged by the study is the lack of clear upper dose guidelines for Adderall, with some practitioners pushing doses beyond the recommended 20 milligrams in pursuit of symptom relief. Moran cautions against the expectation of eliminating all ADHD symptoms with medication alone, noting that both clinicians and patients might sometimes pursue unrealistic outcomes.
Telemedicine companies have faced criticism and lawsuits for allegedly overprescribing Adderall, contributing to shortages and raising concerns about the medication's long-term impact. In response to public outcry, the Drug Enforcement Administration has extended telehealth prescriptions for Adderall through the end of 2024, but the debate around appropriate dosing and monitoring continues.