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I read that patients with ADD can exhibit a hypersensitivity of dopamine in the mesolimbic area and a hyposensitivity of dopamine in the prefrontal cortex which makes them more susceptible to addictive / reward driven behaviour and IMHO also more prone to (drug induced) psychosis as those are conditions postulated by the DH.

I am not entirely sure if recreational drugs release Dopamine in the NAcc and if that can cause positive symptomatic behaviour of schizophrenia / psychosis in conjunction with a hypersensitivity in affected brain regions.

Does this suggest that a patient with ADD and heavy recreational THC use is more likely to evolve psychotic symptoms if balance of D2 activity is not artificially secured?

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  • $\begingroup$ Can you add your sources of information in the post? $\endgroup$
    – AliceD ♦
    Commented Jan 3 at 8:59
  • $\begingroup$ @AliceD Sure, I will add sources later today $\endgroup$
    – Moritz Roessler
    Commented Jan 3 at 10:28

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Having ADHD does increase the risk of drug-induced psychosis. This may be because many of the medications used to treat ADHD are stimulants and stimulants can contribute to the development of psychosis. A recent paper in the New England Journal of Medicine (a top tier medical journal) found that the risk is greatest with amphetamine-based medications (https://pubmed.ncbi.nlm.nih.gov/30893533/). As to the molecular basis of this relationship - I don't think there is a robust explanation.

If someone had ADHD, they certainly should not be using THC. They may wish to be re-assessed after extended abstinence from the THC (plus any other substances) and they may find they don't have ADHD afterall.

One additional note is that psychosis has considerable heterogeneity. There's a lot of focus on dopamine networks but glutamine, GABA, NA, ACh and serotonin may all play some role. It's easy to get caught up with excessive reductionism and cause-effect oversimplification.

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  • $\begingroup$ Why exactly should an individual with AD(H)D not be using THC? I'm more interested in the effects of THC on untreated ADD patients. - I also think that GABA and Serotonin play a role in psychosis. This is purely anecdotal but haven't observed different ACh levels to influence psychotic symptoms (taking ACh blockers while being psychotic). I observe both, Serotonine and Dopamine to have a huge effect on both content and structure/flow of thoughts. $\endgroup$
    – Moritz Roessler
    Commented Jan 7 at 15:30
  • $\begingroup$ Where e.g. paranoia and racing thoughts are affected by both serotonin and dopamine). I haven't had the chance to see how tuning GABA may help with anxiety which is also correlated to thought patterns. Both, increase and decrease of Serotonin has a distinct physical sensation in your body which affects mood and thoughts. Dopamine also affects the mental / physical sensation of your mind. Psychosis is very correlated to thought structure / flow and I think that dopamine / serotonin and gaba augment the same flow of information which plays a role in e.g. auditory hallucinations or delusions $\endgroup$
    – Moritz Roessler
    Commented Jan 7 at 15:31

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