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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, 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 Thumbnail


Authors

Helga Krinzinger

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 Roberts

KAPIL SAYAL kapil.sayal@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry

Edmund Sonuga-Barke

Ian C.K. Wong

Jun Xia

Alexander Zuddas

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry and Digital Mental Health

Kerstin Konrad



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.

Citation

Krinzinger, H., Hall, C. L., Groom, M. J., Ansari, M. T., Banaschewski, T., Buitelaar, J. K., …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

Journal Article Type Article
Acceptance Date Sep 13, 2019
Online Publication Date Sep 20, 2019
Publication Date Dec 1, 2019
Deposit Date Oct 22, 2019
Publicly Available Date Mar 28, 2024
Journal Neuroscience & Biobehavioral Reviews
Print ISSN 0149-7634
Electronic ISSN 1873-7528
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 107
Pages 945-968
DOI https://doi.org/10.1016/j.neubiorev.2019.09.023
Keywords Long-term methylphenidate treatment; ADHD; Adverse neuropsychiatric events; Mood; Anxiety; Suicidal ideation; Bipolar; Psychosis; Substance use disorder; Tics; Seizures; Sleep disorders
Public URL https://nottingham-repository.worktribe.com/output/2919852
Publisher URL https://www.sciencedirect.com/science/article/pii/S0149763419302350?via%3Dihub

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