Clearing Up Questions on Stimulant Medicines in the Treatment of ADHD

March 25, 2019

By: James Parles, MD, Three Village Behavioral Medicine (Three Village, New York)

A recently published article raised concern about starting stimulant medicines in the treatment of ADHD. Children who were stable on stimulant medications did not have similar problems and there is no reason for anyone currently on ADHD medications to stop them.

In the study, the authors analyzed insurance claims and found that a tiny number of patients (0.1-.0.2%) 12 to 25 years old developed symptoms of psychosis, such as hallucinations, soon after beginning stimulant treatment. Here are important take-home points for patients and families:

 • Only patients who are new to stimulants were included in the study. There was no concern raised about patients who are already on stimulants for some time.

 • The authors used insurance claims without access to other clinical information about the patients. This type of study is a useful starting point to help direct researchers who study actual patients. It is not designed to tell doctors and patients what treatments are safe or effective.

 • Any treatment for any illness involves some risk. If the risks from the untreated illness are greater than the risks of treatment, then it makes sense to take the medication. The long term risks of untreated ADHD include higher rates of depression, smoking, substance abuse, unintended pregnancy, school failure, conduct problems, unemployment and law enforcement interaction. Stimulant medication is proven to safely and significantly decrease those risks.

If you have concerns about this topic, or about anything related to the treatment of your child’s ADHD, please discuss them with your prescribing doctor. Together you will be able to make fully informed treatment decisions which integrate knowledge gained from medical science with what you and your doctor know from experience with your child.

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