Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence. (December 2019)

• Record Type: Journal Article
• Authors: 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, Alessandro; Hollis, Chris; Konrad, Kerstin; Liddle, Elizabeth B
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 107(2019)
• Page Start: 945
• Page End: 968
• Publication Date: 2019-12
• Subjects: ADD Attention Deficit Disorder -- ADDUCE attention deficit/hyperactivity disorder drugs use chronic effects study -- ADHD attention deficit/hyperactivity disorder -- AE adverse events -- CHMP committee for medicinal products for human use (European Medicines Agency) -- DSM diagnostic and statistical manual of mental disorders (American Psychiatric Association) -- EEG electroencephalography -- ICD International Classification of Diseases (World Health Organisation) -- IR-MPH Immediate Release methylphenidate -- MPH methylphenidate -- MTA Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study -- OROS-MPH osmotic-controlled release oral delivery system methylphenidate -- SUD Substance Use Disorder -- UK United Kingdom -- US United States; Long-term methylphenidate treatment -- ADHD -- Adverse neuropsychiatric events -- Mood -- Anxiety -- Suicidal ideation -- Bipolar -- Psychosis -- Substance use disorder -- Tics -- Seizures -- Sleep disorders; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2019.09.023
• Languages: English
• ISSNs: 0149-7634

Abstract

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.