Adderall is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.

It comes as a tablet you take by mouth. It’s available in two forms: an immediate-release tablet (Adderall) and an extended-released tablet (Adderall XR). It’s also available as a generic drug.

If you or your child has been prescribed Adderall, you may wonder about possible side effects, including psychosis.

Here’s what you need to know about a possible link between Adderall and psychosis. You’ll also discover who’s at risk for psychosis, as well as tips to help you take this drug safely.

Psychosis is a serious mental condition in which a person’s thinking is so disordered that they lose touch with reality. Symptoms of psychosis can include:

  • hallucinations, or seeing or hearing things that aren’t real
  • delusions, or believing things that aren’t true
  • paranoia, or feeling extremely suspicious

Adderall contains the nervous system stimulants amphetamine and dextroamphetamine. Stimulants can make you feel more alert and focused.

As with any medication, adderall can also cause unwanted side effects.

Studies of Adderall and similar stimulants, such as methylphenidate (Ritalin), estimate that psychosis occurs in about 0.10 percent of users. However, new research with over 300,000 adolescents with ADHD showed that the rates of psychosis in adolescents in the amphetamine group was as high as 0.21 percent.

No one knows the exact reason why Adderall would cause psychosis. Some researchers aren’t really sure that it does.

That said, there are several theories about the relationship between psychosis and Adderall. These theories are based on how the medication works in the body. A few are described below:

Sleep deprivation

One theory is that common side effects of Adderall could contribute to psychotic symptoms. These side effects include:

Continued lack of sleep may cause worsening headaches and extreme nervousness. This may turn into the paranoia linked with psychosis.

Mental illness

If you have a history of mental illness, you may be more likely to develop psychosis from using Adderall. The reason for this isn’t entirely known.

One theory is that your body may respond differently to an increase — caused by Adderall — of certain chemicals in your brain. People with amphetamine-induced psychosis have significantly higher rates of norepinephrine in their blood than amphetamine users without psychosis.

Dosage

Your dosage of Adderall may affect whether or not you develop psychosis. Higher dosages may lead to a higher risk.

ADDERALL AND DEPENDENCESome people who take Adderall develop a tolerance to its effects. They can also feel a psychological and physical dependence on the medication. To help prevent this from happening, take Adderall exactly as directed by your doctor, and don’t stop taking it abruptly. For more information, read about withdrawal from Adderall.

While the risk is highest for people with a history of mental illness, anyone taking Adderall has a small risk for psychosis. Here are steps you can take to help reduce your risk:

Tell your doctor about any mental health issues

Discuss your full health history with your doctor before you start taking Adderall. Be sure to mention any personal or family history of the following:

A history of any of these raises your risk of Adderall-induced psychosis.

Take the medication exactly as prescribed

Take Adderall exactly as your doctor prescribed it. The risk of psychotic symptoms might increase if you take a higher dosage than prescribed.

Tell your doctor right away about mood or behavioral changes

Pay attention to mood and behavior, and let your doctor know if you notice any changes. Talking to your doctor is especially important if you notice mood symptoms that are new or that get worse quickly.

If symptoms of psychosis occur, your doctor will likely stop treatment with Adderall right away.

Psychotic symptoms should go away less than two weeks after you stop the medication. If the symptoms don’t go away, your doctor will likely check for a mental health issue that may need to be treated.

Adderall can be an effective treatment for ADHD symptoms or narcolepsy symptoms. However, if you’re concerned about the side effects of Adderall, talk with your doctor and don’t hesitate to ask questions.

Questions you could ask include:

  • Does Adderall put me (or my child) at higher risk for psychosis?
  • What symptoms of psychosis should I watch for?
  • Are there other drugs that might work that don’t cause psychosis?

Your doctor can help determine if Adderall is a good choice.

Q:

Can Adderall cause other mental health effects?

A:

Long-term use of Adderall can cause other effects on mental health such as irritability, depression, mood swings, panic attacks, and paranoia. If you’ve been taking Adderall or are thinking about starting it and are concerned about mental health side effects, you should speak with your doctor about your family history and the possible side effects of the medication. 

 

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.