Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence
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 K., 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, Alessandro; Hollis, Chris; Konrad, Kerstin; Liddle, Elizabeth B.
Date:
2019-09-20
Copyright:
©2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).T
Citation:
Krinzinger, H., Hall, C. L., Groom, M. J., Ansari, M. T., Banaschewski, T., Buitelaar, J. K., Carucci, S., Coghill, D., Danckaerts, M., Dittmann, R. W., Falissard, B., Garas, P., Inglis, S. K., Kovshoff, H., Kochhar, P., McCarthy, S., Nagy, P., Neubert, A., Roberts, S., Sayal, K., Sonuga-Barke, E., Wong, I. C. K., Xia, J., Zuddas, A., Hollis, C., Konrad, K. and Liddle, E. B. (2019) 'Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence', Neuroscience & Biobehavioral Reviews, 107, pp. 945-968. doi: 10.1016/j.neubiorev.2019.09.023
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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