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

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 - https://www.scopus.com/pages/publications/85074755405

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 -