Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence

ADDUCE Consortium, Helga Krinzinger, Charlotte L. Hall, Madeleine J. Groom, Mohammed T. Ansari, Tobias Banaschewski, Jan K. Buitelaar, Sara Carucci, David Coghill, Marina Danckaerts, Ralf W. Dittmann, Bruno Falissard, Peter Garas, Sarah K. Inglis, Hanna Kovshoff, Puja Kochhar, Suzanne McCarthy, Peter Nagy, Antje Neubert, Samantha RobertsKapil Sayal, Edmund Sonuga-Barke, Ian C. K. Wong, Jun Xia, Alexander Zuddas, Chris Hollis, Kerstin Konrad, Elizabeth B. Liddle

Research output: Contribution to journalReview article

Abstract

Methylphenidate (MPH), the most common medication for children with Attention Deficit/Hyperactivity Disorder (ADHD) in many countries, is often prescribed for long periods of time. Any long-term psychotropic treatment in childhood raises concerns about possible adverse neurological and psychiatric outcomes. We aimed to map current evidence regarding neurological and psychiatric outcomes, adverse or beneficial, of long-term MPH (> 1 year) treatment in ADHD. We coded studies using a "traffic light" system: Green: safe/favours MPH; Amber: warrants caution; Red: not safe/not well-tolerated. Un-categorisable study findings were coded as "Unclear". Although some evidence suggests an elevated risk of psychosis and tics, case reports describe remission on discontinuation. Several studies suggest that long-term MPH may reduce depression and suicide in ADHD. Evidence suggests caution in specific groups including pre-school children, those with tics, and adolescents at risk for substance misuse. We identified a need for more studies that make use of large longitudinal databases, focus on specific neuropsychiatric outcomes, and compare outcomes from long-term MPH treatment with outcomes following shorter or no pharmacological intervention.

Original languageEnglish
Pages (from-to)945-968
Number of pages24
JournalNeuroscience and Biobehavioral Reviews
Volume107
Early online date20 Sep 2019
DOIs
Publication statusPublished - Dec 2019

Fingerprint

Methylphenidate
Attention Deficit Disorder with Hyperactivity
Psychiatry
Tics
Amber
Methyl Green
Therapeutics
Psychotic Disorders
Suicide
Long Term Adverse Effects
Databases
Pharmacology
Depression

Keywords

  • ADHD
  • Adverse neuropsychiatric events
  • Anxiety
  • Bipolar
  • Long-term methylphenidate treatment
  • Mood
  • Psychosis
  • Seizures
  • Sleep disorders
  • Substance use disorder
  • Suicidal ideation
  • Tics

Cite this

ADDUCE Consortium, Krinzinger, H., Hall, C. L., Groom, M. J., Ansari, M. T., Banaschewski, T., ... Liddle, E. B. (2019). Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence. Neuroscience and Biobehavioral Reviews, 107, 945-968. https://doi.org/10.1016/j.neubiorev.2019.09.023
ADDUCE Consortium ; Krinzinger, Helga ; Hall, Charlotte L. ; Groom, Madeleine J. ; Ansari, Mohammed T. ; Banaschewski, Tobias ; Buitelaar, Jan K. ; Carucci, Sara ; Coghill, David ; Danckaerts, Marina ; Dittmann, Ralf W. ; Falissard, Bruno ; Garas, Peter ; Inglis, Sarah K. ; Kovshoff, Hanna ; Kochhar, Puja ; McCarthy, Suzanne ; Nagy, Peter ; Neubert, Antje ; Roberts, Samantha ; Sayal, Kapil ; Sonuga-Barke, Edmund ; Wong, Ian C. K. ; Xia, Jun ; Zuddas, Alexander ; Hollis, Chris ; Konrad, Kerstin ; Liddle, Elizabeth B. / Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD : A map of the current evidence. In: Neuroscience and Biobehavioral Reviews. 2019 ; Vol. 107. pp. 945-968.
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abstract = "Methylphenidate (MPH), the most common medication for children with Attention Deficit/Hyperactivity Disorder (ADHD) in many countries, is often prescribed for long periods of time. Any long-term psychotropic treatment in childhood raises concerns about possible adverse neurological and psychiatric outcomes. We aimed to map current evidence regarding neurological and psychiatric outcomes, adverse or beneficial, of long-term MPH (> 1 year) treatment in ADHD. We coded studies using a {"}traffic light{"} system: Green: safe/favours MPH; Amber: warrants caution; Red: not safe/not well-tolerated. Un-categorisable study findings were coded as {"}Unclear{"}. Although some evidence suggests an elevated risk of psychosis and tics, case reports describe remission on discontinuation. Several studies suggest that long-term MPH may reduce depression and suicide in ADHD. Evidence suggests caution in specific groups including pre-school children, those with tics, and adolescents at risk for substance misuse. We identified a need for more studies that make use of large longitudinal databases, focus on specific neuropsychiatric outcomes, and compare outcomes from long-term MPH treatment with outcomes following shorter or no pharmacological intervention.",
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ADDUCE Consortium, Krinzinger, H, Hall, CL, Groom, MJ, Ansari, MT, Banaschewski, T, Buitelaar, JK, Carucci, S, Coghill, D, Danckaerts, M, Dittmann, RW, Falissard, B, Garas, P, Inglis, SK, Kovshoff, H, Kochhar, P, McCarthy, S, Nagy, P, Neubert, A, Roberts, S, Sayal, K, Sonuga-Barke, E, Wong, ICK, Xia, J, Zuddas, A, Hollis, C, Konrad, K & Liddle, EB 2019, 'Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence', Neuroscience and Biobehavioral Reviews, vol. 107, pp. 945-968. https://doi.org/10.1016/j.neubiorev.2019.09.023

Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD : A map of the current evidence. / ADDUCE Consortium; Krinzinger, Helga; Hall, Charlotte L.; Groom, Madeleine J.; Ansari, Mohammed T.; Banaschewski, Tobias; Buitelaar, Jan K.; Carucci, Sara; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Falissard, Bruno; Garas, Peter; Inglis, Sarah K.; Kovshoff, Hanna; Kochhar, Puja; McCarthy, Suzanne; Nagy, Peter; Neubert, Antje; Roberts, Samantha; Sayal, Kapil; Sonuga-Barke, Edmund; Wong, Ian C. K.; Xia, Jun; Zuddas, Alexander; Hollis, Chris; Konrad, Kerstin; Liddle, Elizabeth B. (Lead / Corresponding author).

In: Neuroscience and Biobehavioral Reviews, Vol. 107, 12.2019, p. 945-968.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD

T2 - A map of the current evidence

AU - ADDUCE Consortium

AU - Krinzinger, Helga

AU - Hall, Charlotte L.

AU - Groom, Madeleine J.

AU - Ansari, Mohammed T.

AU - Banaschewski, Tobias

AU - Buitelaar, Jan K.

AU - Carucci, Sara

AU - Coghill, David

AU - Danckaerts, Marina

AU - Dittmann, Ralf W.

AU - Falissard, Bruno

AU - Garas, Peter

AU - Inglis, Sarah K.

AU - Kovshoff, Hanna

AU - Kochhar, Puja

AU - McCarthy, Suzanne

AU - Nagy, Peter

AU - Neubert, Antje

AU - Roberts, Samantha

AU - Sayal, Kapil

AU - Sonuga-Barke, Edmund

AU - Wong, Ian C. K.

AU - Xia, Jun

AU - Zuddas, Alexander

AU - Hollis, Chris

AU - Konrad, Kerstin

AU - Liddle, Elizabeth B.

N1 - This work was supported by the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement no 324487.

PY - 2019/12

Y1 - 2019/12

N2 - Methylphenidate (MPH), the most common medication for children with Attention Deficit/Hyperactivity Disorder (ADHD) in many countries, is often prescribed for long periods of time. Any long-term psychotropic treatment in childhood raises concerns about possible adverse neurological and psychiatric outcomes. We aimed to map current evidence regarding neurological and psychiatric outcomes, adverse or beneficial, of long-term MPH (> 1 year) treatment in ADHD. We coded studies using a "traffic light" system: Green: safe/favours MPH; Amber: warrants caution; Red: not safe/not well-tolerated. Un-categorisable study findings were coded as "Unclear". Although some evidence suggests an elevated risk of psychosis and tics, case reports describe remission on discontinuation. Several studies suggest that long-term MPH may reduce depression and suicide in ADHD. Evidence suggests caution in specific groups including pre-school children, those with tics, and adolescents at risk for substance misuse. We identified a need for more studies that make use of large longitudinal databases, focus on specific neuropsychiatric outcomes, and compare outcomes from long-term MPH treatment with outcomes following shorter or no pharmacological intervention.

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KW - ADHD

KW - Adverse neuropsychiatric events

KW - Anxiety

KW - Bipolar

KW - Long-term methylphenidate treatment

KW - Mood

KW - Psychosis

KW - Seizures

KW - Sleep disorders

KW - Substance use disorder

KW - Suicidal ideation

KW - Tics

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U2 - 10.1016/j.neubiorev.2019.09.023

DO - 10.1016/j.neubiorev.2019.09.023

M3 - Review article

C2 - 31545988

VL - 107

SP - 945

EP - 968

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

SN - 0149-7634

ER -