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

the ADDUCE Consortium

Research output: Journal PublicationReview articlepeer-review

23 Citations (Scopus)

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
DOIs
Publication statusPublished - Dec 2019

Keywords

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

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience

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