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/ Source: TODAY & # 39; HUI
By Linda Carroll
A new study suggests that some medications used to treat ADHD in adolescents and young adults are more likely to cause symptoms such as paranoia, hallucinations, illusions and voices.
The researchers found that patients aged 13 to 25 who had recently been prescribed amphetamines, such as Adderall and Vyvanse, were more likely to develop psychosis than those who received a prescription for methylphenidates, such as Ritalin and Concerta. , according to the study published in the New England Journal of Medicine.
The key message at home is that these cases involved new prescriptions, or patients who had just started treatment, said NBC medical contributor Natalie Azar on Thursday.
"For people who take these medications, who are responsible for them and who are doing well, there is absolutely no reason to stop them," said Azar. "We can not underestimate the benefits of these medications for treating the symptoms of ADHD."
Although psychosis associated with one or the other class of drugs is still relatively rare – occurring in one out of every 660 patients – it is important that people taking these drugs know about the existence of this or that very serious side effect.
The results of the study provide an opportunity for doctors and families to talk about low risk and be alert to any symptoms when a patient starts treatment, Azar said.
"You have to think about it from a public health perspective," said the lead author of the study, Dr. Lauren Moran, assistant professor at Harvard Medical School and psychiatrist at McLean Hospital. "If it's only a fraction of a million people, it means that there could be thousands more cases of psychosis in the United States." For me, it's a serious problem. "
The prescriptions of amphetamines to treat ADHD have increased rapidly, which has become a source of concern.
"At the beginning of our study, in 2005, a patient had about a 50% chance of getting an Adderall or Ritalin. During the study, the number of Adderall prescriptions dramatically increased to almost four times the number of prescriptions prescribed for Adderall, "said Moran.
As the number of students with psychosis increased, Moran discovered that a common factor among the cases appeared to be the amphetamine prescriptions for ADHD, she said. .
Moran and his colleagues turned to two large business insurance claims databases including more than 5 million patients with a stimulant prescription.
The researchers focused on patients aged 13 to 25 who had started taking amphetamines or methylphenidates between January 1, 2004 and September 30, 2015. Of the 221,846 patients included in the study, 110,923 were taking methylphenidate and 110,923 were taking amphetamines.
New cases of psychosis were identified in 106 patients on methylphenidate, compared to 237 in those on amphetamines, almost double that rate.
The Food and Drug Administration has mandated since 2007 that ADHD drug labels include warnings about potential psychiatric and cardiac problems.
According to Moran's experience, patients with ADHD admitted for psychosis recovered in two weeks on average, but some took up to two months.
Moran does not suggest that drugs for ADHD are too dangerous to be prescribed, but wants to warn patients against its use.
"We are trying to raise awareness," she said. "Physicians need to be aware of this when prescribing and people who get these drugs from college friends need to know that it's a risk."
Other experts have agreed that there should be greater awareness.
The new study underscores the need for physicians to be "extremely attentive to the diagnosis of ADHD and appropriate treatment," said Dr. Antoine Douaihy, a professor of psychiatry and medicine at the Faculty of Medicine at the University of Ottawa. University of Pittsburgh and Senior Academic Director of Addiction. Medical Services of the Medical Center of the University of Pittsburgh. "And they have to watch the patients closely."
Although the study shows that psychosis is a risk for both stimulants, she suggests that amphetamines "may be more involved than methylphenidates," said Dr. David Goodman, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine and director of the Deficit Disorder Treatment Center in Maryland. According to the study, the databases used by the researchers do not contain detailed information on the diagnosis of patients.
Goodman hopes that the study and the coverage it enjoys will force doctors and patients to treat these medications with care. But he hopes that any attention will not scare patients with ADHD medications. It's unclear exactly how many people are taking ADHD medications in the US, but the number of young people taking prescription medications for ADHD has increased dramatically in recent years, according to research.
"If we do not treat it, ADHD has so many negative consequences," said Goodman.