NEW YORK (Reuters Health) – New research suggests that on rare occasions the medications used to treat attention-deficit/hyperactivity disorder may induce hallucinations and other psychotic symptoms.

As reported in the February issue of Pediatrics, Dr. Kate Gelperin, from the US Food and Drug Administration, Silver Spring, Maryland, and colleagues analyzed postmarketing surveillance data and clinical trial data to better characterize the ability of psychostimulants to cause psychosis or mania in children.

The researchers identified 49 randomized, controlled clinical trials that included data on adverse effects of ADHD medications.

In 743 person-years of double-blind treatment with these agents, 11 psychosis/mania adverse events were logged, the report indicates. Thus, the authors calculate that 1.48 psychosis/mania events would occur with 100 person-years of ADHD drug treatment. By contrast, no such events were noted with 420 person-years of placebo exposure.

In examining postmarketing surveillance data, Dr. Gelperin’s team found more than 800 reports of psychotic symptoms or mania associated with ADHD medication use. Moreover, in about 90% of the cases, the child had no history of a psychiatric condition that could explain the symptoms.

Hallucinations were a commonly identified psychotic symptom and often involved visual or tactile sensations of insects, snakes, or worms, the researchers report.

“Patients and physicians should be aware of the possibility that psychiatric symptoms consistent with psychosis or mania, when they arise in the course of drug treatment of ADHD, may represent adverse drug reactions,” the authors conclude.

Reference:
Pediatrics 2009;123:611-616.