Psychosis with Methylphenidate or Amphetamine in Patients with ADHD
Given amphetamines carry a somewhat higher psychosis risk than methylphenidate, does my personal or family mental-health history change which stimulant we should choose?
Well-supported by good-quality research. how we score evidence
Caveat on this rating: Observational claims data; some co-authors disclose consulting fees or equity in health-analytics and pharmaceutical-adjacent companies, though the study itself was NIMH-funded.
In 221,846 insured adolescents and young adults starting a stimulant for ADHD, new-onset psychosis occurred in about 1 in 660 patients, and amphetamine starters had a 65% higher risk than methylphenidate starters (0.21% vs 0.10%).
Worth asking
Given amphetamines carry a somewhat higher psychosis risk than methylphenidate, does my personal or family mental-health history change which stimulant we should choose?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Attention-deficit/hyperactivity disorder (ADHD)
- Narcolepsy
Source
Psychosis with Methylphenidate or Amphetamine in Patients with ADHD — Moran LV, et al. (2019)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1056/NEJMoa1813751
DOI: 10.1056/NEJMoa1813751
How this was scored
- Study design
- Cohort study
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 221,846
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "strong evidence". Well-supported by good-quality research. It scores 79 out of 100 on our published rubric. One caveat travels with that badge: Observational claims data; some co-authors disclose consulting fees or equity in health-analytics and pharmaceutical-adjacent companies, though the study itself was NIMH-funded. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Psychosis with Methylphenidate or Amphetamine in Patients with ADHD — Moran LV, et al. (2019). Published in: Top-tier peer-reviewed journal. DOI: 10.1056/NEJMoa1813751. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is amphetamine (Adderall, Mydayis, Evekeo), adderall, mydayis, evekeo FDA approved?
Yes — FDA approved for Attention-deficit/hyperactivity disorder (ADHD), Narcolepsy. Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.