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ADHD drugs may cause more bad than good

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Researchers have urged caution when prescribing methylphenidate-based drugs to treat Attention Deficit Hyperactivity Disorder (ADHD).

Despite large amounts of research documenting the drug’s usefulness in treating ADHD, evidence that it causes increased sleeplessness and loss of appetite has caused Danish researchers to reconsider its effectiveness.

ADHD is a commonly diagnosed childhood disorder that can continue through adolescence into adulthood. Symptoms include difficulty focusing attention and remaining on task, excessively impulsive behaviour, and extreme hyperactivity. Methylphenidate-based drugs have been used to treat ADHD for more than 50 years.

The researchers reviewed data from 185 randomised control trials involving more than 12,000 children. The studies were conducted in the US, Canada, and Europe and included males and females from ages three to 18 years. The studies all compared methylphenidate-based drugs with either a placebo or no intervention.

The researchers found that methylphenidate led to modest improvements in ADHD symptoms, general behaviour, and quality of life. But an analysis of adverse effects showed children were more likely to experience sleep problems and loss of appetite while on the drug.

The researchers raised concerns over the validity of the data that they examined, saying it was possible participants were aware of which treatment the children were receiving, and the reporting of the results was not complete in many of the trials.

Nonetheless, the researchers urged clinicians to weigh up the benefits and risks more carefully before prescribing methylphenidate-based drugs to treat ADHD.

Lead researcher Professor Ole Jakob Storebo from the Psychiatric Research Unit in Region Zealand, Denmark, said the review highlights the need for long-term, large, and better-quality randomised trials to determine the average effect of the drug more reliably.

The researchers said that clinicians and families should not rush to discontinue using methylphenidate, and if a child or young person has experienced benefits without experiencing adverse effects, then there may be good clinical grounds to continue using it.

Patients and their parents should discuss any decision to stop treatment with their health professional before doing so.

The researched appeared in the British Medical Journal.

Kirsty Waterford