Prescription Stimulant Use is Associated with Earlier Onset of Psychosis


Individuals diagnosed with psychotic disorders have an earlier onset of psychosis if they have previously been exposed to prescription stimulants, according to new research currently in press in the Journal of Psychiatric Research.

This study raises major public health concerns as the rates of ADHD diagnoses and prescription of stimulants continue to rise.  More than five million children between the ages of 3 and 17 were diagnosed with ADHD in 2012.  The overall increase in prescription stimulants, as well as the misuse and off-label prescription of these drugs, has also been well documented.

Stimulant-induced psychosis has been observed since Connell’s studies on amphetamines beginning in 1958.  While research has continued on the development of psychosis in individuals who abuse illegal stimulant drugs, less is known about the long-term risk of psychosis in children and adolescents prescribed amphetamine and methylphenidate for ADHD.

To test the relationship between prescription stimulants and the onset of psychosis, the researchers recruited 239 individuals from an inpatient facility who had been diagnosed with a psychotic disorder.  The researchers then compared previous prescription use of stimulants and the age of onset of psychosis, while controlling for gender, cannabis use, substance abuse, presence of psychosis in immediate family member and level of educational attainment.

Nearly half of the 239 patients reported a history of stimulant use.  Prior use of stimulants was significantly more likely in patients who were younger, male, and had a history of cannabis use.  Though, the onset of stimulant use was found to precede cannabis use by an average of two and a half years.  Most importantly, however, the researchers found a significant correlation between prior stimulant use and an earlier onset of psychosis, even after controlling for potentially confounding factors.

“In this study, we demonstrate the novel finding that prior exposure to prescription stimulants is associated with an earlier onset of psychosis while controlling for potential confounding factors,” the researchers write. “Our sample was largely prescribed stimulants during childhood and adolescence, and the majority of participants were prescribed stimulants for ADHD.”

They conclude: “This is the first study demonstrating an earlier onset of psychosis for medications prescribed for comorbid psychiatric disorders.”




Moran LV, Masters GA, Pingali S, Cohen BM, Liebson E, Rajarethinam RP, Ongur D, Prescription Stimulant Use is Associated with Earlier Onset of Psychosis, Journal of Psychiatric Research (2015), doi: 10.1016/j.jpsychires.2015.09.012. (Abstract)


    • I think what it means is that some kids who are prescribed stimulants later develop psychosis, and that it starts earlier than for people who develop it with no stimulant use. It doesn’t exactly prove that these kids might not have been psychotic without the use of stimulants, but it certainly suggests that may be true. Personally, I’m quite certain that a small number of kids forced to take stimulants when young do develop psychotic symptoms as a result. I am not sure anyone really wants to find out if that’s true or not, as there are so many billions of dollars to be made selling stimulants to help kids cope with the standard, rigid classrooms our society accepts as “normal.”

      I see why it is confusing, but I think they have to put it that way so as not to overstate what they actually learned from the experiment. The next experiment is to match kids who are taking stimulants with similar kids who aren’t, and see if there is more psychosis in the first group, but that one will never get funded, for reasons I mentioned above.

      —- Steve

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      • I suppose I was looking for a definition of the term earlier.

        ““In this study, we demonstrate the novel finding that prior exposure to prescription stimulants is associated with an earlier onset of psychosis while controlling for potential confounding factors,” the researchers write.

        The term earlier struck me as funny, like as if psychosis were wholly expected to occur and there was some biological timing involved.

        Your answer makes sense but it also brings me back into my cuckoo loop, lol.

        “I think what it means is that some kids who are prescribed stimulants later develop psychosis, and that it starts earlier than for people who develop it with no stimulant use.”

        It brings me back into a loop because of those people who develop psychosis without stimulant use (like as if psychosis is biologically expected at a very specific time).

        I don’t know, maybe I’m reading into it too much. It’s just that word, earlier.

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        • I get what you’re saying. There is an assumption that psychosis just somehow “develops” and that stimulants bring it on sooner. Of course, it begs the very important question of whether stimulants themselves are causing the psychosis to occur. Given what we know about stimulants, it seems a very reasonable question to ask, but this is one of psychiatry’s “blind spots,” whether intentionally or unconsciously, I don’t know. All I know is that they generally adopt language that assumes biological causation and inevitability all the time without ever noting the “metacommunication” that is implied. I guess if that’s your view of the world and you’ve never considered another, it doesn’t sound quite so odd.

          —- Steve

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          • I wonder if it’s that “unmasking” thing again, just repackaged in other words.

            In my own experience, effexor xr (I won’t capitalize those words) caused symptoms that most people would call psychosis. I call it brain destabilizing neurotoxic response (which came with brain zaps, a seizure and some permanent disfiguration of my former mind). Not the same class of drugs this article is about but the point is, brain tinkering certainly can and does injure. But of course it does! Plenty enough of us have said so. Jeez.

            And the standing charge against the industry is that they don’t discern between the harm and damage their concoctions cause, and what they think is “disease”. Correct?

            We need approximately 3,948,229 more studies in order to be sure. Any volunteers out there in the world? Call toll free 1-800-totally-lost-brain-researchers

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  1. Also do a study of young adults checking into drug and alcohol treatment centers and see how many of them were given stimulants a kids.

    I have already done an unofficial study just by asking well over 100 in the last few years and the majority answer yes when you ask them if they we drugged in school for ADHD.

    The crash and jitters anxiety insomnia from the ADHD stimulant comedown leads to self medicating with alcohol and opiates leading to addiction.

    Anyone can do one of these unofficial studies, goto an AA or NA meeting that those vans bring clients from drug and alcohol treatment centers and start asking. Or just ask any of the young people attending.

    I am fairly certain you will notice the same thing I have right away, the majority of young people in treatment for alcohol and drug problems were given to stimulant drugs during their childhood and teens.

    “Correlation does not imply causation…” I know all that but I know when the ADHD drugs wear off they cause a craving for a drink or downer pill like opiates to deal with it and drinking and those pills itself becomes addictive.

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  2. This appears to be absolutely predictable. If we look medications functionally, rather than regarding “diagnosis” we would have picked it up earlier I expect. Of course psychiatry has given people at risk, or experiencing psychosis, stimulants in a way abrogating their informed consent and human rights has been made clear upon the site. So, to be expected.
    I write to see it coming out of Harvard University/Maclean Hospital, the home of Dr Joseph Biederman, who has done more than any other professional to escalate the usage of stimulants in young people.

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  3. You would think this was some big surprise. The fact that one can go over the edge and into psychosis is a part of the amphetamine culture with a long history. Hopefully the psychosis is episodic with the drug use and not a chronic after affect.

    Prescription or not this drug takes one down a path that leads the mind away from the spirit. It is the story of a false prophet for sure. How sick is man to inflict this on his children?

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    • “You would think this was some big surprise.”

      I must say, I find stagnation and lots of covering the same old ground, over and over again. Also, the same group of people who have been here for years (not that that’s a bad thing).

      It almost seems like this site is the library of a university. The people are gathered and doing their work, but I don’t see too much beyond it. Of course, I only visit nowadays. I check in, I’m a bit active, then I’m off with other entanglements. Plus, such heavy drug focus is far too much of a trigger for me.

      I think the entire world-wide community of interested people need to have a united epiphany or something.


      I just looked up the word epiphany to make sure I was using it correctly. Had myself a good laugh.

      NO, I don’t mean the sort of Epiphany like JC dropping by to say Hi (lmao)

      I mean this sort of epiphany: 3. A sudden insight or intuitive understanding

      Seriously, though. What is it going to take?

      (btw, for those who don’t know why that was funny… there waits your epiphany).

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  4. I refused to drug my child. I read Ross Greene’s ‘The Explosive Child’, decided that my child’s issues were developmental, and treated him not with pharma but with love and support. Decades will tick on and I expect we’ll see all sorts of other problems that will be linked back to this big, open-air drug experiment that pharma and psychiatry pushed and that parents allowed.

    Liz Sydney

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