Dose-response relationship seen, with increased odds for high doses of amphetamine
By Elana Gotkine HealthDay Reporter
TUESDAY, Sept. 17, 2024 (HealthDay News) — Past-month prescription amphetamine use is associated with increased odds of psychosis and mania, with increased odds for high doses (>30 mg dextroamphetamine equivalents), according to a study published online Sept. 12 in The American Journal of Psychiatry.
Lauren V. Moran, M.D., M.P.H., from McLean Hospital in Belmont, Massachusetts, and colleagues conducted a case-control study using electronic health records to compare the odds of incident psychosis or mania with past-month exposure to prescription amphetamines. Cases were patients aged 16 to 35 years hospitalized for incident psychosis or mania between 2005 and 2019 (1,374 individuals), and controls were patients with an initial psychiatric hospitalization for other reasons, most commonly depression and/or anxiety (2,748 individuals).
The researchers found that compared with no use, past-month prescription amphetamine use was associated with increased odds of psychosis and mania among cases and controls (adjusted odds ratio, 2.68; 95 percent confidence interval, 1.90 to 3.77). There was a dose-response relationship, with high doses of amphetamines (>30 mg dextroamphetamine equivalents) associated with 5.28-fold increased odds of psychosis or mania. Compared with no use, past-month methylphenidate use was not associated with increased odds of psychosis or mania (adjusted odds ratio, 0.91; 95 percent confidence interval, 0.54 to 1.55).
“The clinical utility of prescribing doses of amphetamines that exceed 30 mg dextroamphetamine equivalents is unproven; coupled with the elevated risk of inducing psychosis or mania, we recommend minimizing this practice,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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