This systematic review and meta-analysis evaluates the association between psychosis or bipolar disorder and stimulant treatment among individuals with attention-deficit/hyperactivity disorder.
Methylphenidate and the risk of psychosis in adolescents and young adults: a population-based cohort study
Background There is a clinical concern that prescribing methylphenidate, the most common pharmacological treatment for attention-deficit hyperactivity disorder (ADHD), might increase the risk of psychotic events, particularly in young people with a history of psychosis. We aimed to determine whether the risk of psychotic events increases immediately after initiation of methylphenidate treatment or, in the longer term, 1 year after treatment initiation in adolescents and young adults with and without a previously diagnosed psychotic disorder. Methods In this cohort study, we used population-based observational data from the Swedish Prescribed Drug Register, the National Patient Register, and the Total Population Register, three population-based registers containing data on all individuals in Sweden, to attain data on sex, birth, death, migration, medication use, and psychotic events for all eligible participants. We screened individuals on these registers to identify those receiving methylphenidate treatment, and who were aged 12–30 years at the start of treatment, for their inclusion in the study. We used a within-individual design to compare the incidence of psychotic events in these individuals during the 12-week periods immediately before and after methylphenidate initiation. Longer term risk was assessed by comparing the incidence of psychotic events 12 weeks before methylphenidate initiation and during a 12-week period one calendar year before the initiation of methylphenidate with the incidence of these events during the 12-week period one calendar year after methylphenidate initiation. We estimated the incidence rate ratios (IRR) and 95% CIs of psychotic events after the initation of methylphenidate treatment, relative to the events before treatment, which were defined as any hospital visit (inpatient admission or outpatient attendance, based on data from the National Patient Register) because of psychosis, using the International Classification of Diseases version 10 definition. Analyses were stratified by whether the individual had a history of psychosis. Findings We searched the Swedish Prescribed Drug Register to find eligible individuals who had received methylphenidate between Jan 1, 2007 and June 30, 2012. 61 814 individuals were screened, of whom 23 898 (38·7%) individuals were assessed and 37 916 (61·3%) were excluded from the study because they were outside of the age criteria at the start of treatment, they had immigrated, emigrated, or died during the study period, or because they were administered other ADHD medications. The median age at methylphenidate initiation was 17 years, and a history of psychosis was reported in 479 (2·0%) participants. The IRR of psychotic events in the 12-week period after initiation of methylphenidate treatment relative to that in the 12-week period before treatment start was 1·04 (95% CI 0·80–1·34) in adolescents and young adults without a history of psychosis and 0·95 (0·69–1·30) among those with a history of psychosis. Interpretation Contrary to clinical concerns, we found no evidence that initiation of methylphenidate treatment increases the risk of psychotic events in adolescents and young adults, including in those individuals with a history of psychosis. Our study should reassure clinicians considering initiating methylphenidate treatment for ADHD in adolescents and young adults, and it challenges the widely held view in clinical practice that methylphenidate should be avoided, or its use restricted, in individuals with a history of psychosis. Funding Swedish Research Council, National Institute of Mental Health, UK National Institute of Health Research Nottingham Biomedical Research Centre.
Methylphenidate Treatment and Risk of Psychotic Disorder
This cohort study of a Finnish national multiyear birth cohort uses instrumental variable analysis to investigate whether methylphenidate alters the long-term risk of psychotic disorder in children with attention-deficit/hyperactivity disorder.
Methylphenidate and Short-Term Cardiovascular Risk
This cohort study examines the risks of cardiovascular disease after 6 months of methylphenidate treatment in individuals with attention-deficit/hyperactivity disorder.
ADHD and giftedness: a neurocognitive consideration of twice exceptionality
Current models of cognition and behavioral diagnosis emphasize categorical classification over continuous considerations of function and promote the "differential diagnosis" of various conditions according to observational criteria. However, an overemphasis on a purely behavioral, categorical approach to understanding human function fails to address the comorbidity of different disorders and does not include a consideration of overlapping levels of function, from "pathological" through "normal," to "gifted" or exceptional. The frequent co-occurrence of "gifted" and "pathological" function is thus difficult to understand from a corticocentric and purely behavioral and observational point of view. This article reviews "giftedness" in relation to the diagnosis of attention-deficit hyperactivity disorder, coexistence of which is termed "twice exceptional." It additionally considers problems in assessing these functions using current neuropsychological tests and methodologies that are presumably based upon a corticocentric model of cognition.
For those who’s taking ritalin / stimulants, does it drain you towards the end of the day?
80 votes, 56 comments. Im not sure if I used the right flair… Hello Reddit! I was recently diagnosed with adhd and its been a week since taking…
Successful People With ADHD Superpowers
Explore stories of successful people who have harnessed their ADHD superpowers to achieve greatness.
How the hypercuriosity of ADHD may have helped humans thrive | Aeon Essays
ADHD isn’t merely a dysfunction. It’s best understood as an impulsive motivational drive for novel information
How the hypercuriosity of ADHD may have helped humans thrive | Aeon Essays
ADHD isn’t merely a dysfunction. It’s best understood as an impulsive motivational drive for novel information
ADHD and the Alexander Technique
Some people with ADHD have reported benefits in applying some of the ideas from my materials. What could be going on here? My interest in Alexander Technique’s potential relevance to ADHD arose because quite a few people with ADHD who have engaged with my materials have reported improvement in
The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment
Attention-deficit/hyperactivity (ADHD) symptoms have been associated with the decision to become self-employed. Although these symptoms are generally regarded as disadvantageous, there may also be a bright side. To our knowledge, however, there has been no systematic, epidemiological evidence to support this claim. This paper examines the association between ADHD symptoms and self-employment in a population-based sample from the STAGE cohort of the Swedish Twin Registry (N = 7208). For replication, we used a sample of Dutch students who participated in the Global University Entrepreneurial Spirit Students' Survey (N = 13,112). In the Swedish sample, we found a positive association with self-employment for both general ADHD symptoms [odds ratio (OR) 1.13; 95 % confidence intervals (CI) 1.04-1.23] and hyperactivity symptoms [OR 1.19; 95 % CI 1.08-1.32], whereas no association was found for attention-deficit symptoms [OR 0.99; 95 % CI 0.89-1.10]. The positive association between hyperactivity and self-employment was replicated in the Dutch student sample [OR 1.09; 95 % CI 1.03-1.15]. Our results show that certain aspects of ADHD, in particular hyperactivity, can have a bright side, as they are positively associated with self-employment.
How easy is it to get addicted to methylphenidate?
Hi so I (18m) will start taking prescripted methylphenidate (medikinet) next thursday and i’ve never taken any stimulants (besides caffeine and…
Psychiatry at the Margins | Awais Aftab | Substack
Exploring critical, philosophical, and scientific debates in psychiatric practice and the psy-sciences. Click to read Psychiatry at the Margins, by Awais Aftab, a Substack publication with tens of thousands of subscribers.
ADHD medication rebound
When ADHD symptoms flare up when ADHD medication is wearing off, it’s called medication rebound. Symptoms can be intense for about an hour during rebound. Learn why rebound happens and what can help.
4-Fluoromethylphenidate
4-Fluoromethylphenidate is a stimulant drug that acts as a higher potency dopamine reuptake inhibitor than the closely related methylphenidate.
Hyperactive–impulsive ADHD traits predict higher curiosity in adults: evidence from a cross-sectional study
Attention-deficit/hyperactivity disorder (ADHD) is typically framed in terms of difficulties with sustained attention, behavioral regulation, and impulse control, yet growing work suggests that some associated traits may also relate to potentially adaptive tendencies. Curiosity has been highlighted in qualitative research as one such trait that can function as both a strength and a challenge for adults with ADHD, but quantitative evidence examining its relationship to ADHD traits remains limited. This study examined whether ADHD traits are associated with individual differences in trait curiosity in adults.
