Stimulant Psychosis is a dangerous side effect of adderall (amphetamine salts), ritalin (methylphenidate), vyvanse (lisdexamfetamine) and other stimulants, particularly if abused or taken at high doses. This side effect is an emergency and can consist of patients having hallucinations and/or delusions. Examples include a concern that they (or their house/apartment) are infested by insects (even experiencing crawling sensations on their skin called formication) or that they are being monitored by authorities or going to be arrested. There are many presentations of stimulant induced psychosis, but the bottom line, is that if you or someone you know may be experiencing this, they need immediate medical attention.
Dr. Pagnani has seen this condition many times. Typical doses of adderall (for example) causing this to happen are above 90 mg daily (even up to 150 mg daily or beyond). This is typically seen in substance abusers, but if a patient is particularly vulnerable to this side effect, even FDA approved limits can cause it to happen. Patients (or family members) have reached out to Dr. Pagnani thinking that their family member or friend has schizophrenia or a psychotic bipolar illness, when in fact, it was clearly a substance induced psychosis (and stopping the substance use, as opposed to long-term anti-psychotic use, was the best plan for treatment for these individuals). Antipsychotics can be used short-term, but this should be discussed with the patient's mental health professional.
There are many risks and potential side effects of taking a stimulant medication for ADHD, and it's incredibly important that individuals thoroughly discuss risks and benefits with their provider, before starting, stopping or changing doses of a medication. If someone is abusing these medications, it's incredibly important that they seek professional drug and alcohol treatment.
Dr. Pagnani is the Medical Director of Rittenhouse Psychiatric Associates in Philadelphia, PA and surrounding areas. Their practice has 25 Academically oriented provides and is now scheduling in-office and telemedicine visits.
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