CCHR has documented psychosis and violent behavior linked to any dose of the drugs and wants them prohibited as a treatment for the 3.1 million American children put at risk by taking them.

By CCHR International
The Mental Health Industry Watchdog
September 20, 2024

Taking a high dose of drugs to treat Attention Deficit Hyperactivity Disorder (ADHD) is linked to more than five times greater risk of developing psychosis or mania, according to a new study published in the American Journal of Psychiatry. The research is among the first to find a relationship between escalating doses of the drugs—amphetamines, in particular—and a greater likelihood of psychotic symptoms.[1] Lead researcher, Dr. Lauren Moran stresses the need for a warning label to raise awareness of this serious risk.[2]

CCHR supports the call for a stronger warning label, but given its own documented findings that stimulants are also linked to acts of senseless violence, including school shootings, says the drugs should be removed from the market. Acts of violence are detailed in its comprehensive report, Psychotropic Drugs Create Violence and Suicide.

The ADHD drugs referenced in the study include Adderall, Vyvanse and generic amphetamines, such as dextroamphetamine.[3] Adderall prescriptions in the U.S. soared 27% from 2019 to 2022, according to IQVia, a clinical analytics company.[4] IQVia also reports that 3.15 million 0-17-year-olds took ADHD stimulants, including methylphenidate (Ritalin) in 2020.[5]

Moran apparently found no increased risk of psychosis or mania in prescriptions for methylphenidate (Ritalin).[6] However, there are already international drug regulatory warnings about the drug causing mania or psychosis.[7] A 2023 study published in Cureus advised every medical practitioner prescribing psychostimulants to inform the patient and caregiver about psychosis as a threatening side effect.[8]

The Food and Drug Administration’s (FDA) Medication Guides (Med Guides) for several brand-name ADHD drugs list side effects such as new or worse aggressive behavior or hostility for all patients. For children and teens, there is the warning: new psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic symptoms.[9]

The link between amphetamines and psychosis isn’t new. Amphetamines increase levels of dopamine in the brain and is implicated in psychosis.[10] Moran said that, according to an analysis of national insurance claim data, about 6% of patients taking amphetamines are prescribed the highest dosages and about 22% are prescribed the medium dosages. Patients taking the highest dosages—more than 40 milligrams of Adderall, 100 mg of Vyvanse or 30 mg of dextroamphetamine—were 5.3 times more likely to develop psychosis than patients taking no stimulants. The medium dosage—20 mg to 40 mg of Adderall, 50 mg to 100 mg of Vyvanse or 15 mg to 30 mg of dextroamphetamine—was linked to a 3.5 times higher risk.[11]

However, patients also had a nearly 63% increased risk of psychosis or mania if they took any prescription amphetamine but those on heavy doses of amphetamines were at even greater peril of a psychotic episode, with an 81% increased risk, results show.[12] Vyvanse is also linked to suicidality.[13]

The psychosis could explain why some mass shootings and acts of violence have occurred. According to a Public Library of Science ONE study, researchers took the FDA Adverse Event Reporting System data and identified 31 prescription drugs that were disproportionately associated with violence, of which 25 were psychotropic drugs. The drugs included 11 antidepressants, six sedatives/hypnotics and three drugs for treatment of ADHD, including amphetamines, which were 9.6 times more likely to be linked to violent side effects.[14]

David Kirschner, Ph.D., a New York psychologist stated: “As a forensic psychologist, I have tested/evaluated 30 teenage and young adult murderers, and almost all of them had been in some kind of ‘treatment,’ usually short term and psychoactive drug-oriented, before they killed.” He stressed “Most of the young murderers I have personally examined had…been in ‘treatment’ and were using prescribed stimulant/amphetamine type drugs before and during the killing events. These medications did not prevent but instead contributed to the violence by disinhibiting normal, frontal cortex control mechanisms.”[15]

A sample of cases CCHR has documented includes:

• April 2024: In Västerås, Sweden, a man who attacked and injured three people, along with a woman who burned down the Ica Haga food store, were both prescribed the ADHD drug Elvanse (lisdexamfetamine/Vyvanse). The woman had previously expressed concerns about experiencing psychotic symptoms after starting the drug in 2023 and had even sought emergency care. Medical records indicated that the medication may have triggered her psychosis.[16] She was released from a psychiatric hospital just 30 minutes before she went on her attack.[17]

• August 4, 2019: In Dayton, Ohio, Connor Betts, 24, opened fire outside a bar at 1 a.m., killing nine people, including Bett’s 22-year-old sister, Megan. Police responding to the shooting shot and killed Betts. While the county coroner reported that Betts had cocaine, Xanax and alcohol in his system at the time of the shooting rampage, [18] he also used ADHD drugs like Adderall and Vyvanse to stay high for days.[19]

• February 14, 2018: Nikolas Cruz, 19, went on a shooting spree at Marjory Stoneman Douglas High School in Parkland, Florida, killing 17 people and injuring 17 others.[20] From the age of 6 he’d been labeled with ADHD and prescribed drugs to treat it. From 2008-2017, he was prescribed at various times Focalin and Strattera, as well as the antipsychotics Risperdal and Clonidine to treat ADHD. Ten days after a visit with his psychiatrist, Cruz left a message on his YouTube channel that read, “I’m going to be a professional school shooter.” Then three days before the shooting, Cruz looked into his cellphone camera and declared, “Hello, my name is Nik. I’m going to be the next school shooter of 2018.”Media reported, “While it is not clear how many medications Cruz was taking, the pharmaceutical drugs prescribed for depression and emotional issues are packed with a number of side effects that can lead to violent behavior.”[21]

• November 20, 2014: In Tallahassee, Florida, Myron May, 31,went to Florida State University’s Strozier Librarywhere hundreds of students were studying, and randomly opened fire, wounding three before he was shot and killed by police.He had been prescribed the Vyvanse and the antidepressant Wellbutrin, a combination which can cause paranoia. He started acting strangely and hearing voices, convinced that he was being spied on[22]—i.e., potential psychosis.  

• April 25. 2014: In Milford, Connecticut, Chris Plaskon, 16,stabbed Maren Sanchez, 16, to death in a stairwell at Jonathan Law High School after she turned down his prom invitation.Chris was taking prescribed ADHD drugs.[23] 

• September 8, 2012: In Jackson County, Michigan, Michael Hamilton, 33, shot to death Robert Marcyan, attempted to kill Robert’s twin brother, Richard, and stole two cars to try to flee police. Just months before the shooting, Michael’s daily dosage of Adderall was more than doubled. He was sentenced to life imprisonment.[24] 

• September 21, 2011: In Myrtle Beach, South Carolina, Christian Helms, 14, had two pipe bombs in his backpack, when he shot and wounded a Socastee High School’s “resource” (police) officer. However, the officer was able to stop Helms before he could cause further harm. Helms had been taking drugs for ADHD and depression.[25]

• January 19, 2007: In Sudbury, Massachusetts, John Odgren, 16, stabbed another student to death with a large kitchen knife at Lincoln-Sudbury Regional High School. In court, his father testified that Odgren was prescribed Ritalin. [26] He was sentenced to life in prison.[27]

In May 2023, the FDA also finally acknowledged that ADHD drugs can cause addiction, even when used as prescribed, and required this information to be added to its black box warning on all stimulant drugs.[28]

Given the serious risks from these psychotropic drugs, CCHR reiterates the need for their complete removal, especially for treatment in children and adolescents.

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[1] Akshay Syal, M.D.,” High doses of ADHD drugs linked to a greater risk of psychosis,” Yahoo! News, 12 Sept. 2024, https://www.yahoo.com/news/high-doses-adhd-drugs-linked-110000596.html?fr=yhssrp_catchall

[2] “A new warning about common ADHD meds from Boston-area psychiatrist,” NBC Boston, 12 Sept. 2024, https://www.nbcboston.com/news/local/adhd-medication-warning/3485513

[3] Akshay Syal, M.D.,” High doses of ADHD drugs linked to a greater risk of psychosis,” Yahoo! News, 12 Sept. 2024, https://www.yahoo.com/news/high-doses-adhd-drugs-linked-110000596.html?fr=yhssrp_catchall

[4] Allison Gatlin, “The Byzantine Adderall Shortage Puts Teva And Others In The Hot Seat” Investor’s Business Daily, 4 May 2023, https://www.investors.com/news/technology/teva-stock-what-we-know-and-do-not-about-the-adderall-shortage/

[5] https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/

[6] Dennis Thompson, “High doses of ADHD meds might trigger psychosis,” UPI, 12 Sept. 2024, https://www.upi.com/Health_News/2024/09/12/high-doses-ADHD-meds-psychosis/8841726154262/

[7] Khadija Pasha, et al., “Psychosis Induced by Methylphenidate in Children and Young Patients With Attention-Deficit Hyperactivity Disorder,” Cureus, Jan 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9970721/; https://www.cchrint.org/psychiatric-drugs/stimulantsideeffects/ritalinsideeffects/

[8] Khadija Pasha, et al., “Psychosis Induced by Methylphenidate in Children and Young Patients With Attention-Deficit Hyperactivity Disorder,” Cureus, Jan 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9970721/

[9] https://www.cchrint.org/2023/05/16/fda-finally-adds-addiction-to-black-box-warning-on-adhd-drugs/

[10] Akshay Syal, M.D.,” High doses of ADHD drugs linked to a greater risk of psychosis,” Yahoo! News, 12 Sept. 2024, https://www.yahoo.com/news/high-doses-adhd-drugs-linked-110000596.html?fr=yhssrp_catchall

[11] Akshay Syal, M.D.,” High doses of ADHD drugs linked to a greater risk of psychosis,” Yahoo! News, 12 Sept. 2024, https://www.yahoo.com/news/high-doses-adhd-drugs-linked-110000596.html?fr=yhssrp_catchall

[12] Dennis Thompson, “High doses of ADHD meds might trigger psychosis,” UPI, 12 Sept. 2024, https://www.upi.com/Health_News/2024/09/12/high-doses-ADHD-meds-psychosis/8841726154262/

[13] Jan Larrson, Researcher, “A Contribution to the forthcoming Periodic Safety Update Report (PSUR) assessment report for lisdexamfetamine (Elvanse/Vyvanse) aimed to be completed September 2024, Sweden, 4 July 2024

[14] Psychotropic Drugs Create Violence and Suicide, https://www.cchrint.org/pdfs/violence-report.pdf, citing Thomas J. Moore, Joseph Glenmullen, Curt D. Furbert, “Prescription Drugs Associated with Reports of Violence Towards Others,” Public Library of Science ONE, Vol. 5, lss. 12, Dec. 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002271/

[15] Psychotropic Drugs Create Violence and Suicide, citing David Kirschner, PhD, “Mass shooters received only limited treatment,” The National Psychologist, 26 Jul. 2017, https://web.archive.org/web/20141223021510/http://nationalpsychologist.com/2014/09/mass-shooters-received-only-limited-treatment/102638.html

[16] “Vanlig adhd-medicin kan ge psykos – våldsdåd och mordbrand i Västerås kopplas till adhd-medicinen Elvanse,” SVT Nyheter, 28 May, 2024, https://www.svt.se/nyheter/lokalt/vastmanland/vanlig-adhd-medicin-kan-ge-psykos-valdsdad-och-mordbrand-i-vasteras-kopplas-till-adhd-medicinen-elvanse (English Translation: “Common ADHD medication can cause psychosis – acts of violence and arson in Västerås is linked to the ADHD medication Elvanse”); https://www.malaymail.com/news/world/2024/04/19/swedish-police-shoot-arrest-man-after-three-women-attacked/129784#google_vignette)

[17] https://ground.news/article/woman-discharged-from-her-psyche-30-minutes-later-she-started-the-fire-at-ica-haga-in-vasteras

[18] https://www.cchrint.org/2021/04/20/cchr-renews-calls-for-investigation-into-psychiatric-drug-induced-mass-killings/; Dan Whitcomb, “Dayton gunman had cocaine, Xanax, alcohol in his system during attack,” Reuters, 15 Aug. 2019, https://www.reuters.com/article/us-usa-shooting-ohio/dayton-gunman-had-cocaine-xanax-alcohol-in-his-system-during-attack-idUSKCN1V600V

[19] Pritha Paul, “Dayton shooter was obsessed with drugs, mental illness and Lucifer, wrote about ‘hunting’ down students,” MEAWW.com, 9 Aug. 2019, https://meaww.com/dayton-shooter-connor-betts-journal-recorded-thoughts-on-satanism-drugs-murder-and-mental-illness

[20] https://www.cchrint.org/florida-school-shooter-timeline/; https://www.buzzfeed.com/briannasacks/authorities-were-called-to-alleged-florida-school-shooter?utm_term=.oa47mByJm#.psKga1rXa; https://www.history.com/this-day-in-history/parkland-marjory-stoneman-douglas-school-shooting

[21] https://www.cchrint.org/florida-school-shooter-timeline/; “Family Say Florida School Shooter Was On Big Pharma Antidepressants,” News Punch, 17 Feb. 2018, https://newspunch.com/florida-school-shooter-antidepressants/

[22] https://www.cchrint.org/school-shooters/; Michael Laforgia, “FSU shooter’s friends tried to get help for him months before the shooting,” Miami Herald, 22 Nov 2014, http://www.miamiherald.com/news/state/florida/article4064977.html; Jordan Culver, et al., “Shooter identified as Florida State alum Myron May,” Tallahassee Democrat, 21 Nov 2014, https://www.tallahassee.com/story/news/local/fsu-news/2014/11/20/shooter-identified-fsu-alum-myron-may/70007494/ ; Family of Myron May say the suspected FSU shooter planned on cooking Thanksgiving dinner,” ABC Action News, 20 Nov 2014, https://web.archive.org/web/20150723035827/http://www.abcactionnews.com/news/region-tampa/family-of-myron-may-say-the-suspected-fsu-shooter-planned-on-cooking-thanksgiving-dinner

[23] https://www.cchrint.org/school-shooters/#_edn4; Michael Zennie, “EXCLUSIVE: Boy, 16, who stabbed girl to death after she refused to go to prom because she was dating his friend ‘was depressed and on heavy meds’, devastated classmates reveal,” Daily Mail, 26 Apr 2014, https://www.dailymail.co.uk/news/article-2613894/Pictured-The-boy-16-stabbed-friend-death-refused-prom-going-boyfriend.html; Vivian Yee and Nate Schweber, “Suspect in School Attack Once Turned to Victim for Help, Friends Say,” The New York Times, 27 Apr 2014, http://www.nytimes.com/2014/04/28/nyregion/suspect-in-school-attack-had-sought-help-from-victim-friends-say.html?hpw&rref=nyregion&_r=1

[24] https://www.cchrint.org/psychiatric-drugs/drug_warnings_on_violence/recent-murdersmurder-suicides/, citing Danielle Salisbury, “Doctor prescribed Michael Hamilton Adderall, increased dosage; prosecution suggests prescription overuse,” MLive.com, 9 Oct 2013, https://www.mlive.com/news/jackson/2013/12/michael_hamilton_sentenced_to.html

[25] https://www.cchrint.org/school-shooters/; Harriet McLeod, “South Carolina teen faces adult charges for school attack,” Reuters, March 18, 2011, https://www.reuters.com/article/us-crime-pipebomb-teen-idUSTRE72H7VO20110318; Joel Allen, “Students welcome Officer Karney back to Socastee High,” CarolinaLive.com, September 28, 2010,  https://wpde.com/features/education-news/students-welcome-officer-karney-back-to-socastee-high

[26] https://www.cchrint.org/school-shooters/; “Odgren’s father says son didn’t remember attack,” Telegram.com, April 21, 2010, https://www.telegram.com/story/news/state/2010/04/21/odgren-s-father-says-son/51630809007/

[27] “John Odgren, Mass. Teen, Convicted of Killing Student, Faces Life; Jury Rejects Insanity Claim,” CBS News, 30 Apr. 2010, https://www.cbsnews.com/news/john-odgren-mass-teen-convicted-of-killing-student-faces-life-jury-rejects-insanity-claim/; “John Odgren Denied Appeal In Lincoln-Sudbury HS Stabbing,” Patch, 4 Oct. 2019, https://patch.com/massachusetts/sudbury/john-odgren-denied-appeal-lincoln-sudbury-hs-stabbing; “Fatal Stabbing At Mass. High School,” CBS News, 19 Jan. 2007, https://www.cbsnews.com/news/fatal-stabbing-at-mass-high-school/

[28] https://www.cchrint.org/2023/05/16/fda-finally-adds-addiction-to-black-box-warning-on-adhd-drugs/, citing “FDA updating warnings to improve safe use of prescription stimulants used to treat ADHD and other conditions,” Food and Drug Administration, 11 May 2023, https://www.fda.gov/media/168066/download