Abstract
Use of methylphenidate in children has increased substantially, despite conflicting evidence regarding efficacy. In this study, prescription data were analyzed in relation to the publication of new evidence regarding efficacy. Incidence rates and prescribed doses of methylphenidate increased, with a decline during the last few years. Duration of use is still increasing. In half of the cases, starting dosages are higher than recommended in guidelines. There was little evidence that publication of new evidence directly influenced the use of methylphenidate. Recent and critical study findings should receive more attention to contribute to the development and use of treatment guidelines for ADHD and evidence-based methylphenidate use.
Highlights
In the Netherlands, as in many other Western countries (Bachmann et al 2017; Stephenson et al 2013; McCarthy et al 2012; Zuvekas and Vitiello 2012), the number of methylphenidate (MPH) prescriptions for children has increased substantially over the past 20 years, even quadrupling from 2003 to 2013 (Health Council of the Netherlands 2014)
The MTA study concluded that medication trounced behavioural therapy for children with attention-deficit hyperactivity disorder (ADHD); combining both treatments did not lead to better results compared to medication alone (Jensen 1999)
Since our results indicate there seems to be a slight change in prescription trends for children with ADHD in the past few years, future research could investigate whether this trend continues and incidence rates and dosing continue declining
Summary
In the Netherlands, as in many other Western countries (Bachmann et al 2017; Stephenson et al 2013; McCarthy et al 2012; Zuvekas and Vitiello 2012), the number of methylphenidate (MPH) prescriptions for children has increased substantially over the past 20 years, even quadrupling from 2003 to 2013 (Health Council of the Netherlands 2014). The MTA study was the first study to examine the short- and long-term safety and relative efficacy of medication and behaviour therapy alone or in combination and compared these treatments to routine community care. The MTA study concluded that medication trounced behavioural therapy for children with ADHD; combining both treatments did not lead to better results compared to medication alone (Jensen 1999). Recent studies, including the third MTA follow-up (Molina et al 2009), concluded that medication was efficacious in reducing ADHD behaviour in the short term (Schachter et al 2011), but there was no evidence that this medication benefits children in the long term (Riddle et al 2013; Smith et al 2010; Vogt and Lunde 2018). The most recent MTA follow-up, a 16-year follow-up into
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