Home » Resources » Research Articles » Psychotic Side Effects of Psychostimulants: A 5-Year Review

Psychotic Side Effects of Psychostimulants: A 5-Year Review

Canadian Journal of Psychiatry, Vol 44, October 1999

Esther Cherland, MD, FRCPC, Renée Fitzpatrick, MB, MRCPsych, FRCPC

Objective: To examine the rate of psychotic and mood-congruent psychotic side effects of stimulant medications in children treated for attention-deficit hyperactivity disorder (ADHD).

Method: A chart review was completed of all children diagnosed with ADHD in an outpatient clinic from January 1989 to March 1995.

Results: Over 5 years, 192 children were diagnosed with ADHD. Ninety-eight children received treatment at the clinic with stimulants. Six children developed psychotic or mood-congruent psychotic symptoms during treatment. Children on medication were followed for an average of 1 year and 9 months.

Conclusions: Awareness of the potential for psychotic side effects from stimulant medications is important when prescribing for children. A large prospective study would be useful to predict the frequency and classification of the side effects in children.

Psychotic symptoms are well-known side effects of all stimulant medications (1). Caplan and Tanguay reported that medications such as pseudoephedrine, antihistamines (promethazine hydrochloride, tripolidine hydrochloride), and methylphenidate (MPH) have been reported to induce hallucinations (2). Psychotic symptoms in children who are prescribed MPH for attention-deficit hyperactivity disorder (ADHD) are described as rare, brief, and occurring with treatment within the therapeutic dose range (3,4). Tactile and visual hallucinations and delusions have been reported (5–9). There is no case in the literature of the psychotic reaction persisting after medications have been stopped (10).

Key Words: children, stimulants, side effects, attention deficit, psychosis, mood-congruent psychosis

To read more of this article visit The National Library of Medicine