No Causal Link Seen Between Stimulant Prescription, Psychotic Experience

No evidence observed for causal effect of stimulant prescription on subsequent psychotic experiences when applying doubly robust estimation

By Elana Gotkine HealthDay Reporter

MONDAY, May 12, 2025 (HealthDay News) — Stimulant prescriptions do not appear to have a causal relationship with psychotic experiences, according to a study published online May 12 in Pediatrics.

Kirstie O’Hare, Ph.D., from the Centre for Clinical Brain Sciences at the University of Edinburgh in the United Kingdom, and colleagues estimated the causal effect of stimulants on psychotic experiences in a trial emulated using Adolescent Brain Cognitive Development Study data. The analytical sample included 8,391 participants, aged 9 to 14 years; 460 (5.5 percent) reported one or more prescriptions for a stimulant.

The researchers found that stimulant prescription was associated with subsequent psychotic experiences in unweighted analyses (odds ratio, 1.46). However, the reverse was also true, with baseline psychotic experiences predicting subsequent stimulant treatment (odds ratio, 1.93). No evidence was seen for a causal effect of stimulant prescription on the subsequent occurrence of psychotic experiences when applying doubly robust estimation.

“Our findings suggest that although there is an increased risk of psychotic experiences in children and adolescents who are prescribed stimulant medication, this increased risk is driven by patient characteristics rather than by stimulant treatment itself,” the authors write.