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 drug-induced 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.
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry, Psychology and Neuroscience.
authors.forename: Lynn E
authors.initials: LE
authors.lastname: MacKenzie
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Sabina
authors.initials: S
authors.lastname: Abidi
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Lukas
authors.initials: L
authors.lastname: Propper
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Alexa
authors.initials: A
authors.lastname: Bagnell
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada;
authors.forename: Jessica
authors.initials: J
authors.lastname: Morash-Conway
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada;
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Glover
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada;
authors.forename: Jill
authors.initials: J
authors.lastname: Cumby
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Tomas
authors.initials: T
authors.lastname: Hajek
authors.affiliation: University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
authors.forename: Frauke
authors.initials: F
authors.lastname: Schultze-Lutter
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Pajer
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Departments of Psychiatry.
authors.forename: Martin
authors.initials: M
authors.lastname: Alda
authors.affiliation: Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada; Departments of Psychiatry, Psychology and Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and Medical Neuroscience, and Public Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; uher@dal.ca.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
mesh_terms: D000293:Adolescent; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D016241:Child of Impaired Parents; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy* / Q000453:epidemiology; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants