Abstract
BackgroundThere is no conclusive evidence that stimulants have beneficial effects on major associated outcome parameters, particularly school performance. We assessed the differences in school performance among children using methylphenidate at the end of primary school in relation to various parameters of methylphenidate use.MethodsWe linked children from a pharmacy prescription database with standardized achievement test results at the end of primary school. We explored differences in test scores between current methylphenidate users versus never users and methylphenidate users who stopped treatment at least 6 months before the test, early versus late starters, different dosage of methylphenidate, and concurrent antipsychotic or asthma treatment.ResultsOut of the 7736 children, 377 (4.9%) children were treated with methylphenidate at the time of the test. After adjusting for confounders the methylphenidate users (532.58 ± .48) performed significantly lower on the test than never users (534.72 ± .11). Compared with late starters of methylphenidate treatment (536.94 ± 1.51) we found significantly lower test scores for the early starters (532.33 ± .50).ConclusionOur study indicates that children using methylphenidate still perform less at school compared to their peers. Our study also suggests that earlier start of methylphenidate treatment is associated with a lower school performance compared to children starting later with the treatment. This result could either indicate a limited effect of long term treatment or a more strongly affected group of early starters.
Highlights
There is no conclusive evidence that stimulants have beneficial effects on major associated outcome parameters, school performance
This study shows that methylphenidate users have a lower school performance compared to children who have no history of Attention-deficit/Hyperactivity disorder (ADHD) medication
It could be that normalization of school performance only occurred in children without comorbid learning disabilities and therefor lowered the result of our analyses.In our study, we found that early starters of methylphenidate treatment had significantly lower school performance than children starting later with the treatment
Summary
There is no conclusive evidence that stimulants have beneficial effects on major associated outcome parameters, school performance. We assessed the differences in school performance among children using methylphenidate at the end of primary school in relation to various parameters of methylphenidate use. The negative impact of ADHD on school performance is profound. Children with ADHD have been shown to have lower grades, lower mathematics and reading achievement scores, and a higher rate of school dropout and grade retention [2,3,4,5]. In this study we explored the differences in school performance at the end of primary school between children using methylphenidate and their peers. We assessed differences in school performance among various relevant subgroups and characteristics of medication use
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