Sarah found herself enveloped in a haze of confusion as she grappled with a mysterious ailment that seemed to have taken hold of her life.
Each attempt to eat spiraled into bouts of violent sickness. Her body was a tempest—drenched in sweat with a heart pounding like a runaway train, driving her into sleepless nights.
The 26-year-old, using a pseudonym to maintain her privacy, initially chalked up her deteriorating health to a virus. However, as the days extended into a bout of worsening symptoms, her instincts pointed elsewhere.
A thought gradually crystallized: the onset of her troubles coincided with her switch to a different medication for her attention deficit hyperactivity disorder (ADHD).
ADHD, a condition impacting around 15.5 million adults and nearly seven million children in the United States, is characterized by ongoing challenges with focus, impulsivity, and sometimes, hyperactivity.
Diagnosed in 2021, Sarah had been prescribed lisdexamfetamine, sold under the brand name Vyvanse. It had controlled her symptoms well, she says.
But when her health insurer stopped covering the dose she needed, her psychiatrist prescribed an alternative medication containing methylphenidate, also known as Relexxii.
And that, she realized, is when her problems began.
Jacob Wooderson, a 28-year-old from London, died of cardiac arrest after his ADHD medication dose was increased
‘I had almost no physical energy, but I felt mentally hyper for some reason,’ said Sarah. ‘I was so confused, dizzy and anxious, I actually thought I could be dying.
‘And then I suddenly thought, this all started when I was switched to Relexxii. I tried to call my doctor, but couldn’t get through.
‘The pharmacist suggested going to urgent care, but I felt too dreadful – so I decided just to stop taking the tablets.’
Within 24 hours, the vomiting had eased. Over the following week, she slowly began to recover, although it took several weeks for her to feel back to normal.
Sarah has since found a new psychiatrist, who prescribed a different ADHD medication that controls her symptoms without causing the same side effects.
But the experience has left her shaken.
‘I had no idea a medication could make you feel like that,’ she said. ‘It was terrifying.’
Sarah’s reaction was severe. But millions of Americans take ADHD medication – often for years, and sometimes for life.
And, according to some experts, remarkably little is known about the long-term benefits and risks of taking these drugs.
The issue came into sharp focus last year when a British coroner linked the death of a 28-year-old finance worker to his ADHD medication.
Jacob Wooderson, from London, suffered sudden arrhythmic death syndrome – when a young and seemingly healthy person dies of cardiac arrest – shortly after his dose of Elvanse, also known as lisdexamfetamine, was increased.
In the wake of his death, experts on both sides of the Atlantic warned that the case highlighted broader questions about the safety of ADHD treatments.
There is little doubt these medications have transformed many patients’ lives. But psychiatrists who spoke to the Daily Mail say major questions remain over their long-term effectiveness and their possible effects on both physical and mental health.
The most commonly prescribed ADHD medications – including lisdexamfetamine, mixed amphetamine salts (Adderall) and methylphenidate (Ritalin and Concerta) – are stimulants.
They work by increasing levels of the brain chemicals dopamine and norepinephrine, which help regulate attention, motivation, alertness and impulse control.
By boosting the activity of these chemical messengers, the drugs can help people concentrate for longer, reduce impulsive behavior and, for many, better manage the symptoms of attention deficit hyperactivity disorder.
Spider-Man and The Odyssey star Tom Holland, 30, has shared that he has both ADHD and dyslexia
Simone Biles, 29, revealed she had ADHD after her medical records were leaked, saying she had taken medication since childhood and insisting there was ‘nothing to be ashamed of’
Olympic hero Michael Phelps, 41, was diagnosed with ADHD aged nine and learned to channel his symptoms into his record-breaking career after stopping medication as a teenager
Although non-stimulant medications are also available, they account for a minority of prescriptions.
Until relatively recently, ADHD was widely regarded as a childhood disorder that many youngsters would eventually grow out of.
Today, it is increasingly recognized as a lifelong neurodevelopmental condition. As a result, millions of adults now take ADHD medication every day, with many expected to remain on treatment for years – if not decades.
Awareness of the condition has also been boosted by high-profile figures speaking openly about their diagnoses, including Olympic gymnastics champion Simone Biles, actor Tom Holland and swimming legend Michael Phelps.
Biles, now 29, revealed she had ADHD after her confidential medical records were leaked following the 2016 Rio Olympics. She was reportedly diagnosed at nine years old, and said she had taken medication since childhood and insisted there was ‘nothing to be ashamed of.’
Holland, 30, has spoken about being diagnosed with ADHD and dyslexia as a child, while 41-year-old Phelps has said he was diagnosed aged nine and learned to channel his symptoms into his record-breaking swimming career after stopping medication as a teenager.
The number of prescriptions for ADHD medications reflects this shift in attitude.
Stimulant prescriptions nearly doubled over the past decade, climbing from 50.4 million in 2012 to 80.8 million in 2023 – a 60 percent increase.
That shift, some experts say, has raced ahead of the evidence.
‘There’s no way to know they’re safe if you take them for life because we’ve studied them for at most a few months, and most drug studies of this sort do not focus very thoroughly on adverse effects,’ Professor Joanna Moncrieff told the Daily Mail.
‘The benefits are not clear-cut at the very least. Lots of people do not benefit, and we don’t know whether those benefits are sustained if people take the medication for long periods either.’
Among the biggest concerns are the effects these drugs may have on the heart.
Stimulants are known to increase heart rate and blood pressure, prompting doctors to exercise caution in patients with existing cardiovascular disease.
More recently, a growing body of research has raised questions about whether years of treatment could also increase the risk of more serious heart problems.
A landmark 2024 Swedish study of more than 278,000 people with ADHD found that taking the drugs for longer than three to five years was associated with a 23 percent higher risk of cardiovascular disease overall, with particularly large increases in the risk of high blood pressure.
A second study, published in 2025, found that adults with pre-existing conditions – especially heart disease – were far more likely to experience cardiovascular side effects while taking stimulant medication.
‘To be clear, that association does not establish that the medication directly caused those outcomes,’ board-certified psychiatrist Dr Barry K Herman told the Daily Mail. ‘But it does reinforce the need for ongoing monitoring rather than treating stimulant prescriptions as ‘set it and forget it’.’
The American Heart Association recommends clinicians assess patients for fainting, dizziness with exertion, chest pain, and family history of sudden cardiac death before prescribing stimulants.
‘Physicians should review patient cardiovascular and psychiatric history and obtain baseline blood pressure, pulse, weight, and height before prescribing stimulants,’ Goodman said.
‘Older adults on stimulant medications should have regular monitoring of their vital signs and, for adults over 40, a regular checkup with a primary care provider and occasional electrocardiogram.’
Another area attracting growing attention is a possible link between long-term stimulant use and Parkinson’s disease, although the evidence remains limited.
One population study, published in Neuropsychopharmacology, found that people prescribed psychostimulants for ADHD were more likely to develop Parkinson’s disease or related movement disorders later in life than those who had not received the drugs.
‘The neurological effects are something people need to know about,’ Professor Moncrieff said.
‘That’s based on a small number of studies looking at Parkinson’s and related disorders in people taking both recreational and prescribed stimulants. To me, it hasn’t received as much attention as it deserves.’
Stimulant prescriptions nearly doubled over the past decade, climbing from 50.4 million in 2012 to 80.8 million in 2023 – a 60 percent increase
The above chart shows ADHD rates in the US compared to other countries
Psychosis is another concern.
Research has linked high doses of amphetamine-based ADHD medications to an increased risk of new-onset psychosis or mania, although experts stress that such reactions remain rare.
‘The risk of psychosis is rare but real,’ New York psychiatrist Dr Dan Goodman told the Daily Mail.
A study published in BMJ Mental Health followed more than 16,000 adults in Iceland who began ADHD medication between 2010 and 2022. Within a year, 61 patients—around one in 264—had been hospitalized with their first episode of psychosis or mania.
‘Although important, these findings should be placed in context,’ Goodman said. ‘The absolute risk remains low, and observational studies cannot prove that stimulants caused psychosis. However, the evidence is consistent with other research suggesting higher doses of amphetamine-based stimulants carry a greater risk than methylphenidate.’
He said patients should be prescribed the lowest effective dose and monitored closely, particularly when starting treatment or increasing their dose.
Some patients also report more subtle psychological changes while taking stimulant medication. Rather than dramatic side effects, they describe feeling emotionally flattened or less like themselves.
‘[The medications] damp emotions,’ Moncrieff said. ‘They seem to work by increasing people’s focus on boring things and reducing their tendency to think laterally and creatively.’
The above graph, from the CDC’s 2009 report, shows the gradual rise in ADHD diagnoses among children. Among boys, it is now at 14.5 percent
Prescriptions for stimulants surged 60 percent between 2012 and 2023, from 50.4 million to 80.8 million
The above, from the CDC’s most recent report, shows proportion of children ever diagnosed split by age group and gender
She believes some patients can also experience emotional blunting that affects relationships and their sense of identity.
‘The emotional numbing is likely to interfere with relationships and people’s ability to empathize with others,’ she said.
Then there is another question: just how much benefit do these drugs provide over the long term?
There is little doubt ADHD medications can improve focus and reduce hyperactivity in the short term. But a growing body of research suggests those immediate improvements do not always translate into better grades, higher academic achievement or lasting improvements in quality of life.
A 2024 umbrella review of 115 meta-analyses found no high-certainty evidence that any ADHD treatment – drug or non-drug – delivered sustained long-term benefits.
Perhaps the most influential evidence comes from the landmark Multimodal Treatment Study of ADHD (MTA), the largest long-term trial of ADHD treatment.
While medication produced significant improvements initially, those benefits had largely disappeared by the three-year follow-up.
Sixteen years later, researchers found no evidence that people who continued taking medication had fewer ADHD symptoms than those who did not.
Professor Moncrieff said: ‘People taking amphetamines might think they’re doing brilliantly.
‘But we need objective research on whether they actually improve people’s performance, and the research that we have does not suggest that they do.’
Experts stress that none of this means people should stop taking their medication.
‘When discussing ADHD medications, it’s important to have a balanced perspective,’ Dr Lauren Grawert, a double board-certified psychiatrist and addiction psychiatrist, told the Daily Mail.
‘They can dramatically improve people’s lives, reducing accidents and helping at school, work and in everyday life. But they should be carefully monitored over time.’
Dr Omotolu Aje-Omokore, a psychiatric mental health nurse practitioner who treats ADHD patients, said: ‘These medications deserve the same thoughtful prescribing and ongoing monitoring as any other treatment,’ he said.
‘When the right medication is matched to the right patient, with regular follow-up and open communication, the benefits often far outweigh the risks.’
