Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorders, with prevalence rates around 3%-4%. Medication is frequently used to treat the symptoms of inattention, impulsivity, and hyperactivity that are associated with the disorder. It’s a developmental disorder, meaning that the symptoms start in childhood, before the age of 12. The symptoms can impair functioning in school and at home, and interfere with forming and keeping friendships.
I’m a psychologist and I don’t prescribe medication, but despite that fact, parents often ask me, “Should my child with ADHD be on medication?” followed by, “What are the downsides of medication?” and then frequently follow up with, “Aren’t there too many kids on medication anyway?” A study published last fall in BMJ can help parents and professionals with answers to these questions in terms of the drug methylphenidate, in particular.
Methylphenidate is the most commonly prescribed drug for ADHD worldwide. It’s known by a number of brand names, including Ritalin, Concerta, Metadate, Daytrana, and Quillivant. Although it has been used for over 50 years to treat ADHD — and studies have found it to be effective in decreasing the symptoms of inattention, impulsivity, and hyperactivity — there had been no comprehensive, systematic reviews of the benefits and risks of this drug until this study.
What we’ve learned about methylphenidate
For the study, the investigators reviewed hundreds of papers that had examined the effects of methylphenidate for ADHD. Their analysis found that methylphenidate did improve children’s performance in the classroom. In other words, teachers reported fewer symptoms of ADHD and better general behavior when kids with ADHD were taking the medication. In addition, parents reported a better quality of life for the family when their children were taking medication.
On the other hand, there was some evidence that methylphenidate comes with the risk of side effects, including sleep problems and decreased appetite. These side effects are considered “non-serious adverse effects.” However, if you’re a parent of a child who isn’t sleeping or eating, these may seem quite serious. The good news is that there was no evidence that methylphenidate increases serious side effects, which would include life-threatening problems — that is, something that would require a hospital stay or result in a life-long condition.