MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Methylphenidate is the first-choice drug treatment of attention-deficit/hyperactivity disorder (ADHD), which affects around 5.3% children and adolescents worldwide. For 50 years, psychotic symptoms have occasionally been reported in relation to methylphenidate treatment – however, it has not been established whether the symptoms occur as an adverse event to the treatment.
We performed a systematic review on the topic. The data we included in our study are a subset and an update of data from the most comprehensive systematic reviews of methylphenidate to date. Despite this, we could not confirm or refute whether psychotic symptoms occur as an adverse event. The data are too sparse, and the quality of evidence is too low.
MedicalResearch.com: What should readers take away from your report?
Response: Methylphenidate treatment may cause psychotic symptoms in 1.1% to 2.5% of children and adolescents with ADHD. Physicians, patients and their caregivers should be aware of this possible adverse event. However, concerns about this rare possible adverse event should of course be balanced against the potential beneficial effects of methylphenidate on ADHD symptoms, general behaviour and quality of life.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In future studies, psychotic symptoms should be assessed concurrently with other possible adverse events and beneficial effects of methylphenidate treatment of ADHD in children and adolescents. Psychotic symptoms, the severity and implication for the child/adolescent ought to be assessed by clinical interviews. Of course, high-quality, long-term randomized placebo-controlled trials are on the top of the wish list, but long-term placebo administration is ethically questionable, and therefore also non-randomized studies may be of great importance.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study was funded by the Region Zealand Research Foundation, Denmark; Psychiatric Research Unit, Region Zealand, Slagelse, Denmark; the Copenhagen Trial Unit, the Centre for Clinical Intervention Research, Copenhagen University Hospital, Denmark. For conflicts of interest please see the original article (p. 16).
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