TY - JOUR
T1 - Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD
T2 - A map of the current evidence
AU - The 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.
AB - 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.
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
UR - http://www.scopus.com/inward/record.url?scp=85074755405&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2019.09.023
DO - 10.1016/j.neubiorev.2019.09.023
M3 - Review article
C2 - 31545988
SN - 0149-7634
VL - 107
SP - 945
EP - 968
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
ER -
