New research suggests that dosage plays a role in a rare side effect of A.D.H.D. stimulants.
Julianna McLeod, 26, had her first psychotic episode while taking Vyvanse for attention deficit-hyperactivity disorder last year.
Ms. McLeod, who lives in Ontario, Canada, had taken the drug before but paused while pregnant with her first child and didn’t start taking it again until six months postpartum.
Although the dose was 40 milligrams, she often forgot when she had last taken a pill. So she took one whenever she remembered — and may have ended up taking more than her prescribed daily dose.
The delusions that she experienced made her feel euphoric and highly energetic.
“I felt like my brain was exploding with connections,” she said. In her mind, she was a “super detective” who was uncovering the people and organizations that were secretly engaging in child sex trafficking.
She even began to believe that someone was drugging her and her baby.
Psychosis and mania are each known side effects of stimulant medications, and the Food and Drug Administration has added warnings to the medications’ labels saying that they may cause symptoms like hallucinations, delusional thinking or mania. But these side effects are considered rare — experienced by an estimated 1 in 1,000 patients — and have not been extensively researched. It can take months for someone to fully recover.
A new study published on Thursday in The American Journal of Psychiatry suggests that dosage may play a role. It found that among people who took high doses of prescription amphetamines such as Vyvanse and Adderall, there was a fivefold increased risk of developing psychosis or mania for the first time compared with those who weren’t taking stimulants.
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