ADHD Drugs: Hallucinations Not Uncommon

FDA Examines Incidence Of Psychotic Symptoms In Children Taking ADHD Medications

(WebMD)  Treatment-related hallucinations and other psychotic symptoms in children with attention deficit hyperactivity disorder (ADHD) may be more common than previously thought, FDA officials report in the latest issue of the journal Pediatrics.

In an earlier investigation, FDA researchers identified more than 850 separate incidences of hallucinations and other psychotic episodes among children taking stimulants used to treat ADHD.

The investigation prompted federal officials to require new labeling on the drugs, including Ritalin LA, Concerta , Adderall XR, Focalin, Focalin XR, Metadate CD, Daytrana, and Strattera , warning of possible psychiatric side effects.

An estimated 2.5 million children and teens take these and other stimulant-based medications to treat ADHD symptoms.

Nearly half of the cases of hallucination and other psychiatric side effects reviewed by FDA researchers involved children younger than age 11.

And in more than nine out of 10 cases, the children had no reported history of psychiatric events.

Bugs, Worms, and Snakes
Hallucinations involving insects, snakes, or worms were among the most commonly reported psychiatric events among children and teens, FDA medical epidemiologist and drug safety expert Kate Gelperin, MD, MPH, tells WebMD.

"Some children described feeling a sensation of bugs or worms crawling on their skin," she says.

One case detailed in the report involved a 12-year-old boy with cerebral palsy who said he saw roaches surrounding him two hours after taking an ADHD drug containing methylphenidate. The hallucination lasted several hours, recurred when the boy took an additional dose of the drug, but stopped altogether when the drug was discontinued.

An analysis of 49 randomized clinical trials found that for every 100 children who take ADHD drugs for a year, between one and two experience a drug-related psychotic event.

But in the Pediatrics report, the FDA researchers conclude that this estimate is probably low, in part because the clinical trials often excluded children with a history of adverse reactions to ADHD drugs.

"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 FDA researchers write.

Cardiovascular Concerns
ADHD researcher William Pelham Jr., PhD, tells WebMD that hallucinations and similar psychiatric symptoms are well known to clinicians who specialize in treating children with the disorder.

Pelham is a professor of psychology, pediatrics, and psychiatry at the State University of New York at Buffalo.

"Off the top of my head, I would say I have seen this in about one out of every 100 kids I've treated," he says.

But he adds that pediatricians and other clinicians who don't specialize in treating
ADHD may fail to associate psychotic episodes with stimulant drug use.

He notes that the drugs have also been linked to sudden death in children with heart problems. It is now recommended that children be evaluated for heart problems before beginning treatment with ADHD medications.

"The hope is that reports like this one will raise awareness that these are not benign medications. They are psychoactive drugs with side effects," he says.

Warnings Included on Labels
A spokesman for Shire Pharmaceuticals, which markets extended-release Adderall XR, tells WebMD that there is little new information in the published FDA report and that the drug s labeling now includes a warning about possible psychiatric side effects, including hallucination.

Stimulant medications are proven, safe treatments for people with ADHD, says Shire Director of Corporate Communications Matt Cabrey. But with any medication there is a risk for adverse events, and these drugs are no exception.

Eli Lilly and Co. spokesman David Shaffer also noted that the labeling for Strattera was altered to warn of possible psychiatric side effects after the FDA first made its concerns public.

[jsilver2th]

These ''bug'' hallucinations are similar to the ones caused by meth and it is no wonder since these substances are nothing more than amphetamines.

Now young people do get benefits from these drugs- why I know of one case out here in the wild west where the young man actually sold his Ritalin to his father instead of using it himself-

[kuching88]

It is our drug laws that are responsible for the 5,600 people killed last year in Mexico due to drug violence. In comparison, only 4,154 US soldiers have been killed in Iraq since March 2003.
Posted by andylance1

America learned nothing from ALCOHOL PROHIBITION.
Prohibition causes crime and violence.
DRUG PROHIBITION IS THE PROBLEM.

[andylance1]

Legal psychoactive drugs claim 2.5 million children as victims . The schools demand it, doctors prescribe it and the FDA approves it. It is a huge windfall for the pharmaceutical companies. The FDA is completely corrupted by the drug companies.

The taxpayers spend $2.4 billion to pay for the DEA each year to fight illegal drugs. We just gave Mexico $400 million to fight drug gangs. Marijuana is the largest cash crop in America worth billions.

It is our drug laws that are responsible for the 5,600 people killed last year in Mexico due to drug violence. In comparison, only 4,154 US soldiers have been killed in Iraq since March 2003.

[kuching88]

I cannot attest to other drugs but I took Ritalin when young. It was VERY helpful. When no longer needed, I stopped taking Ritalin without ill effect.

One must wonder if drugs like Ritalin cause hallucinations and hysterical behaviors in those who DO NOT take them?!

Seems to me there is a lot of unjustified anti-pharma, anti-science sentiment coming from the ignorant and superstitious.

[incog-nito]

What about the dour, scolding comments made by people who are constantly offended by, of all things, anonymous internet postings. Such people can always go to ANY internet forum to get their fill of indignation.

[confeddunces]

The insensitivety and paranoia that readers feel towards the treatment of this neurological disorder - is staggering. ADHD is life long and complicated so please stop and show some respect on the matter.

[brainteaser2]

Give a four year old a fist of amphetamines - then figure out why their stoned out of their minds - daa

[forever1973]

Often (not always), these drugs are used as a substitute for proper behavior modification techniques.

I have first-hand experience with this.

[incog-nito]

Well, I do find that I''m much calmer when I just sit there enjoying my hallucinations.

[ljb6599]

many children take stimulant medication including my daughter and do not experience hallucinations.Any medication can cause side effects even aspirin.Show me the evidence that adderall causes cancer????

[brainteaser2]

Why is this surprising give a kid a handful of amphetamines and I wonder why he''s hallucinating?

[lilbeards1]

Anyone dealing with ADHD needs to read this book: The Diseasing of America''s Children by John Rosemond. The first twenty pages can be read here: http://www.pd-go.com/files/upload-21725.pdf