english.prescrire.org > Spotlight > 100 most recent > Hyperactivity in children with attention deficit disorder: methylphenidate only as a last resort

Spotlight

Every month, the subjects in Prescrire’s Spotlight.

100 most recent :  1 | 10 | 20 | 30 | 40 | 50 | 60 | 70 | 80 | 90

Hyperactivity in children with attention deficit disorder: methylphenidate only as a last resort

Behaviour therapy is effective in most cases of hyperactive children with attention deficit disorder. Methylphenidate must remain a last resort, particularly because of the risk of serious adverse effects, including fatal cardiac effects.

In children, the diagnosis of "hyperactivity with attention deficit disorder" is based on vaguely defined, non-specific symptoms. In around 75% of cases, behaviour therapy is effective. Methylphenidate is an amphetamine that should only be used as a last resort in some children whose behaviour remains disruptive and has a negative impact on social, school and family life, and when non-drug therapy has proved unsuccessful.

The US Food and Drug Administration's pharmacovigilance data confirm that methylphenidate, already known to increase arterial pressure and heart rate, causes serious cardiovascular adverse effects and has even been implicated in several fatalities.

Methylphenidate exposes the patient to disproportionate risks in the case of over-prescription, in particular in children who are simply boisterous. Methylphenidate must only be used in a few very specific situations.

©Prescrire June 2006

Source: "Méthylphénidate : risques cardiovasculaires" Rev Prescrire 2006 ; 26 (272) : 343.

- More articles in Prescrire's "Spotlight"...