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International Journal of Clinical Case Studies Volume 1 (2015), Article ID 1:IJCCS-103, 3 pages
http://dx.doi.org/10.15344/2455-2356/2015/103
Case Report
Psychosis Requiring Hospitalization in an Adult ADHD Patient on a Therapeutic Stimulant: A Case Report and Review of Treatment Alternatives

Mary Gable1* and Dwayne Depry2

1Psychiatry Department, UCSF Fresno, 155 North Fresno Street, Fresno CA 93701,United States
2Chief of Inpatient Psychiatry, VA Central California Health Care System, 2615 E Clinton Ave, Fresno, CA 93703, United States
Dr. Mary Gable, Psychiatry Department, UCSF Fresno, 155 North Fresno Street, Fresno CA 93701,United States; E-mail: mgable@fresno.ucsf.edu
10 March 2015; 30 March 2015; 01 April 2015
Gable M, Depry D (2015) Psychosis Requiring Hospitalization in an Adult ADHD Patient on a Therapeutic Stimulant: A Case Report and Review of Treatment Alternatives. Int J Clin Case Stud 1: 103. doi: http://dx.doi.org/10.15344/2455-2356/2015/103

Abstract

Introduction: This is a case of a patient on therapeutic dextroamphetamine for adult ADHD who developed severe psychotic symptoms requiring hospitalization and anti-psychotic medication. While there are case reports of patients who abuse stimulants or do not take them as directed, there is little in the literature describing those who take moderate doses as prescribed, particularly over a short duration, and develop florid psychosis.
Case Presentation: A 26 year old male who suffered from adult attention-deficit hyperactivity disorder (ADHD) was brought to the attention of the psychiatric consult-liaison service as he suddenly developed psychotic symptoms after taking a prescribed stimulant three times per day for a short duration. He ultimately required a four-day hospitalization in inpatient psychiatry with medication management lasting nearly two weeks before complete symptom resolution was achieved.
Conclusion: Patients taking stimulants as prescribed for the treatment of ADHD may be at risk of developing psychosis. It is essential that patients be monitored closely on initiation of treatment and during induction for behavioral changes. Fortunately, there are a variety of pharmacologic and behavioral treatment modalities that do not include stimulants, but that are proven effective and can be used as alternatives in such cases.