Direct-to-consumer (DTC) advertising of pharmaceuticals is a controversial topic within healthcare and psychiatry, with only two countries (US and New Zealand) allowing this practice. Proponents argue that DTC drug advertising educates patients, encourages appropriate diagnoses, reduces stigma, and lowers drug prices. Critics say this practice misleads patients, overestimates the benefits of drugs, leads to overprescription, lacks regulation, and increases costs. Patient influencers, described by some experts as “the next frontier in direct-to-consumer marketing,” are social media personalities that promote drugs through their online presence and personal health journeys. A new study published in the Journal of Attention Disorders explores this next frontier of drug marketing by analyzing TikTok content around prescription stimulants.
The current work, led by Benjamin Johnson from the University of Queensland in Australia, finds that portrayals of prescription stimulant use on TikTok are mostly positive, highlighting improvements to daily life and downplaying the negative effects of these drugs. This study additionally finds that the people posting this content are mainly young white women. The content included in this study averaged more than 300,000 views per video, indicating significant reach and influence, especially among younger people. The authors write:
“Videos frequently depicted substantial improvements in daily functionality and emotional well-being attributed to prescription stimulants, with side effects presented as manageable … The vast reach of these videos, with an average of over 300,000 views and nearly 40,000 likes each, underscores their significant potential to influence public perceptions about prescription stimulants. ”
While the TikTok content examined in the current work shares many similarities with DTC marketing, it is important to note that the authors did not collect data related to industry sponsorship of these videos. This study likely includes both sponsored and unsponsored content.
Harms Linked to Direct-to-Consumer Drug Marketing and Patient Influencers
Research has linked DTC drug marketing to overprescription, increased mental health stigma, and worse treatment. Experts have also warned that this kind of marketing inflates anxiety around specific diagnoses, framing everyday experiences as pathological and allowing industry to leverage these concerns to push its products on people that likely cannot benefit from their use.
A 2025 article featured in BMJ outlines many problems specific to patient influencers. The authors warn that patient influencers can exploit the strong bond they have with their audience for commercial gain. This includes receiving free products, creating sponsored content, and affiliate marketing programs. There are no regulations in place requiring patient influencers to disclose industry payments, which can blur the line between personal recommendation and marketing pitch. These content creators often promote unnecessary medical tests to healthy populations such as full body MRI scans and specialized blood tests. This can result in increased anxiety and overdiagnosis. This study also found that many patient influencers are promoting risky and unproven alternative treatments, including their own personally branded supplements, courses, and “healing protocols.”
Study Details
The goal of the current research was to investigate how prescription stimulants are portrayed on the social media platform TikTok, as well as the potential influences this content may have on public perceptions and demand for these drugs.
The authors searched TikTok for content related to stimulant prescriptions by using the hashtags #Vyvanse, #Adhdmedication, and #Adderall. They then searched additional hashtags included in the most popular videos from their initial search. This process was repeated until no new hashtags could be identified. The researchers screened all identified hashtags and excluded any that were not relevant to prescription stimulants. Hashtags that had less than 10 million total views were also excluded to ensure that included content was widely viewed.
The final content search included the following 11 hashtags: #Vyvanse, #Adhdmedication, #Adderall, #Adhdmeds, #Adderalshortage, #Elvanse, #Adderalcheck, #Vyvansesquad, #Concerta, #Vyvansetok, and #Adderaltiktok. In total, the authors examined 548 TikTok videos. Only videos in English were included in the current analysis.
The average number of views for included videos was 324,987. Fifty-eight percent of included videos featured young adults, 82% featured a white person, and 70% featured a woman. The majority of videos fell into the personal experience genre (61.6%). Other genres included memes (26.5%) and informational (12.4%). The authors identified four overarching themes repeated in these videos: positive effects, context of use, negative effects, and systemic challenges.
Positive effects of prescription stimulants were depicted in 223 videos. Cognitive benefits were the most commonly depicted positive effect and were mentioned in 110 videos. Videos also depicted benefits to motivation and productivity (68 videos), positive changes in mood and reduced anxiety (46), positively framed weight loss (22), behavioral regulation (19), and social skills (18).
The context of use category focused on how these drugs benefited specific tasks. Benefits related to specific tasks were featured in 141 videos. This included improved daily task management (69), aiding in work and study (49), improved domestic efficiency such as cleaning and daily chores (26), and enhanced enjoyment of hobbies and leisure activities (16).
Negative effects were depicted in 187 videos. This included physical symptoms like headache, nausea, and increased heart rate (56), appetite suppression (46), insomnia (31), mood swings, increased anxiety, cognitive fog, and other symptoms related to the drugs wearing off (37), negative emotional or psychological effects (29), tolerance (19), and “other” (23). The authors report:
“It is crucial to note the distinct tone used when discussing side effects compared to positive impacts. While many users acknowledged experiencing side effects, the majority did not express an intention to discontinue medication use or describe these side effects as significantly impairing their lives. Instead, individuals often framed them as inconveniences rather than major obstacles.”
Systemic challenges related to prescription stimulant use were featured in 126 videos. Videos depicted systemic challenges in terms of healthcare barriers such as access and insurance (48), drug shortages (60), drug authenticity including lack of efficacy (28), and stigma related to prescription stimulant use (22).
The authors conclude that the combination of depicting substantial improvements and minimizing negative effects related to prescription stimulant use “may significantly influence audience perceptions, particularly among similar demographics, potentially contributing to an increased demand for these medications.”
Limitations
This study has several limitations. The authors only examined content on one social media platform. These results may not be generalizable to other platforms. Non-English content was excluded. While the study included information on views, there is no way to know how people reacted to this content. For example, people could have been ridiculing the videos rather than taking them seriously. This means the actual significance and reach of this content is difficult to quantify. The authors did not include data on industry sponsorship of this content. This is likely due at least in part to the lack of regulation around patient influencer content.
While it is unclear to what extent the content creators examined in the current work were compensated by pharmaceutical companies, the authors observe that these videos have the cadence of DTC drug marketing. This means the effects may be similar to DTC marketing, even for unsponsored content.
“The portrayal of stimulant medication on platforms like TikTok exhibits similarities with direct-to-consumer (DTC) pharmaceutical advertising. The content employs emotive and anecdotal narratives that focus on improved quality of life and well-being, similar to tactics used in DTC advertising.”
Additionally, these videos seem to be designed to target women, a demographic that is less likely to use prescription stimulants compared to men.
“We also identified a predominance of young women among the content creators of prescription stimulant content on TikTok, despite ADHD being prescribed more often to males … According to social identity theory, individuals are more influenced by and trust information from those similar to themselves, or their ‘ingroup.’ This means young women may be particularly receptive to these videos, potentially driving the rising demand for ADHD diagnosis and medication among this demographic.”
The similarity between patient influencer content and DTC drug marketing, the focus on demographics that have been less likely to use these products in the past, and industry adjacent publications recommending working with and compensating patient influencers are all evidence that patient influencer content may be, to some extent, a guerrilla marketing tactic employed by industry to create more demand for its products.
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Johnson, B., Sun, T., Wu, L., Seal, S., Stjepanovic, D., Chan, G., & Leung, J. (2025). Content analysis of the portrayal of prescription stimulants on TikTok. Journal of Attention Disorders, 29(8), 617–627. https://doi.org/10.1177/10870547251318834
This indicates what we are up against.
It will only get worse.
My guess is that these are paid marketing firms masquerading as individuals, but I could be wrong about that.
Our only defense against this crap is to break their paradigm in a very big way, and thus destroy their narrative.
This will not be easy but I see no other way. I don’t fall for this crap, but my paradigm shifted when I was still a young man. Most people I know still think the mind is in the brain; even “intelligent” adults. So we have a long way to go.
And even if all these drugs were illegal, we’d still have people taking them, because addiction is a whole other subject and a huge problem on Earth.
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I am sure you are right about financial investment or even authorship by corporations posing as “consumers” or “influencers.” It is such a corrupt field, and the articles described sound way to much like pharmaceutical advertising to be coincidental.
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“There are no regulations in place requiring patient influencers to disclose industry payments” I’m not entirely sure this is correct. In the United States, the FTC guidelines on when an internet personality is compensated for advertising generally require disclosure. That’s not to say that these guidelines are strictly enforced, in fact there is a pandemic of undisclosed advertising on short-form platforms such as tiktok.
As for individual users touting positive effects, perhaps they’re just people with mild/misdiagnosed with ADHD. Without the burden of what would be traditionally considered disability they’re just perpetually taking a stimulant and reaping its short term benefits.
I don’t use tiktok but my theory above comes from my viewing of psychiatric-positive content on places like Youtube (i.e. people with very mild disability or exposure to psychiatrics pushing a very positive view after 5mg of Lexapro, prescribed by their general care practitioner, curing all their ales)
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I also think it’s worth noting that disclosure alone doesn’t appear to alter the effectiveness of industry propaganda efforts. I’d imagine most people ignore any disclosure statements and continue to believe what “feels right” regardless of disclosed conflicts of interest.
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