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

Krinzinger H, Hall CL, Groom MJ, Ansari MT, Banaschewski T, Buitelaar JK, Carucci S, Coghill D, Danckaerts M, Dittmann RW, Falissard B, Garas P, Inglis SK, Kovshoff H, Kochhar P, McCarthy S, Nagy P, Neubert A, Roberts S, Sayal K, Sonuga-Barke E, Wong IC, Xia J, Zuddas A, Hollis C, Konrad K, Liddle EB (2019)

Publication Type: Journal article, Review article

Publication year: 2019

Journal

Book Volume: 107

Pages Range: 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.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Aachen (UKA) Germany (DE) University of Nottingham United Kingdom (GB) University of Ottawa Canada (CA) Universitätsklinikum Mannheim Germany (DE) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) Netherlands (NL) Università degli Studi di Cagliari Italy (IT) The University of Melbourne Australia (AU) University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven Belgium (BE) Université Paris-Sud France (FR) Semmelweis University / Semmelweis Egyetem Hungary (HU) University of Dundee United Kingdom (GB) University of Southampton United Kingdom (GB) University College Cork (UCC) Ireland (IE) VADASKERT Child and Adolescent Psychiatry Hospital and Outpatient Clinic Hungary (HU) NHS foundation trust United Kingdom (GB) King’s College London United Kingdom (GB) University College London (UCL) United Kingdom (GB) University of Nottingham Ningbo China China (CN)

How to cite

APA:

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

MLA:

Krinzinger, Helga, et al. "Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence." Neuroscience and Biobehavioral Reviews 107 (2019): 945-968.

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