Stimulant medication and psychotic symptoms in offspring of parents with mental Illness

Lynn E. MacKenzie; Sabina Abidi; Helen L. Fisher; Lukas Propper; Alexa Bagnell; Jessica Morash-Conway; Jacqueline M. Glover; Jill Cumby; Tomas Hajek; Frauke Schultze-Lutter; Kathleen Pajer; Martin Alda; Rudolf Uher

doi:10.1542/peds.2015-2486

Stimulant medication and psychotic symptoms in offspring of parents with mental Illness

Lynn E. MacKenzie, Sabina Abidi, Helen L. Fisher, Lukas Propper, Alexa Bagnell, Jessica Morash-Conway, Jacqueline M. Glover, Jill Cumby, Tomas Hajek, Frauke Schultze-Lutter, Kathleen Pajer, Martin Alda, Rudolf Uher^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

Abstract

BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to druginduced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. Methods: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. Results: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P =.001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. Conclusions: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.

Original language	English
Article number	e20152486
Journal	Pediatrics
Volume	137
Issue number	1
DOIs	https://doi.org/10.1542/peds.2015-2486
Publication status	Published - 1 Jan 2016

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@article{46964d6d452b40fba847f19ec68db53d,

title = "Stimulant medication and psychotic symptoms in offspring of parents with mental Illness",

abstract = "BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to druginduced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. Methods: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. Results: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P =.001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. Conclusions: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.",

author = "MacKenzie, {Lynn E.} and Sabina Abidi and Fisher, {Helen L.} and Lukas Propper and Alexa Bagnell and Jessica Morash-Conway and Glover, {Jacqueline M.} and Jill Cumby and Tomas Hajek and Frauke Schultze-Lutter and Kathleen Pajer and Martin Alda and Rudolf Uher",

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doi = "10.1542/peds.2015-2486",

language = "English",

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T1 - Stimulant medication and psychotic symptoms in offspring of parents with mental Illness

AU - MacKenzie, Lynn E.

AU - Abidi, Sabina

AU - Fisher, Helen L.

AU - Propper, Lukas

AU - Bagnell, Alexa

AU - Morash-Conway, Jessica

AU - Glover, Jacqueline M.

AU - Cumby, Jill

AU - Hajek, Tomas

AU - Schultze-Lutter, Frauke

AU - Pajer, Kathleen

AU - Alda, Martin

AU - Uher, Rudolf

PY - 2016/1/1

Y1 - 2016/1/1

N2 - BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to druginduced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. Methods: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. Results: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P =.001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. Conclusions: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.

AB - BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to druginduced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. Methods: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. Results: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P =.001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. Conclusions: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.

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DO - 10.1542/peds.2015-2486

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VL - 137

JO - Pediatrics

JF - Pediatrics

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ER -

Stimulant medication and psychotic symptoms in offspring of parents with mental Illness

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