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Quantifying the Benefits and Risks of Methylphenidate as Treatment for Childhood ADHD

FORUM FOR PSYCHIATRY RESIDENTS :: Psychiatry :: Psychiatry-Neurology-Psychology discussion :: Psychiatry In Depth

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Quantifying the Benefits and Risks of Methylphenidate as Treatment for Childhood ADHD Empty Quantifying the Benefits and Risks of Methylphenidate as Treatment for Childhood ADHD

Post  Admin Tue May 24, 2016 7:18 pm

Quantifying the Benefits and Risks of Methylphenidate
as Treatment for Childhood ADHD


JAMA published this article on May 10, 2016 (JAMA. 2016;315(18):1953-1955) which summarizes Cochrane review (BMJ. 2015;351:h5203) to evaluate the benefits and risks of methylphenidate (MPH) as treatment for childhood ADHD.


Important Findings:


(1) 
* Based on rating by teachers: MPH associated with improvement of core symptoms of ADHD and general behavior problems.
* Based on clinical impression by parents: MPH associated with parent's clinical impression of improved child's quality of life.
Goodluck


(2) 
* Methylphenidate associated with non serious side effects- decreased appetite and Insomnia.
* This increase not found for serious adverse events.


(3) 
* Authors reports that all of 185 included trials were flawed- high risk of bias. Authors questioned the therapeutic benefit of MPH and do not support the inclusion of MPH in treatment guidelines for ADHD.
Sad1

Sources of Bias considered by authors:
* How randomization was conducted
* Concealment of allocation
* Participants and personnel blinding
* Outcome assessment bliniding
* Incomplete outcome date
* Selective reporting
* Vested interest bias
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