title: [Prescription of methylphenidate for children: importance of recommendations to limit misuse].
abstract: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder appearing during childhood. Multimodal strategies have been developed to treat this disorder, some of them including medication. To this day in France, prescriptions are mainly based on methylphenidate. Ever since this drug was marketed in France in 1995, it has been subject to enhanced monitoring, mainly because of the risk of dependence, abuse, and misuse. The present study aims at assessing (1) whether the recommendations on methylphenidate use for children are being respected, (2) the extent of problematic use of methylphenidate, and (3) the impact of said recommendations being respected on the development of problematic consumption. We studied patients who were treated with methylphenidate in an academic child psychiatry department. We specifically developed a semistructured interview grid for this study. Both parents and children were interviewed. In almost three out of four cases, at least one recommendation had not been followed (52% of patients did not follow the recommendation of stopping use during weekends and holidays). We found an average of 1.6 (range, 0-5) recommendations that were not respected. In almost two out of three cases, the consumption of methylphenidate was problematic; for 40% of children, this meant the search for at least one effect other than the expected therapeutic effects, such as an intellectual, creative, or athletic boosting effect. Approximately one-third of parents also sought an effect other than therapeutic for their child. Conversely, if all of the prescription recommendations were followed, less problematic consumption was observed. Methylphenidate-based treatments must therefore be implemented after a specialist has evaluated the patient and be prescribed following the recommendations. In this context, the treatment's benefits are undeniable.
authors: CEIP-addictovigilance, service de pharmacologie clinique, institut de biologie, 9, quai Moncousu, 44093 Nantes cedex 1, France.
authors: A
authors: A
authors: Chéron-Blümel
authors: EA 4275 « biostatistique, recherche clinique et mesures subjectives en santé », UFR de pharmacie, 1, rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France; Service universitaire d'addictologie et de psychiatrie de Liaison, hôpital St-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. Electronic address: marie.bronnec@chu-nantes.fr.
authors: M
authors: M
authors: Grall-Bronnec
authors: CEIP-addictovigilance, service de pharmacologie clinique, institut de biologie, 9, quai Moncousu, 44093 Nantes cedex 1, France; EA 4275 « biostatistique, recherche clinique et mesures subjectives en santé », UFR de pharmacie, 1, rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France.
authors: C
authors: C
authors: Victorri-Vigneau
authors: CEIP-addictovigilance, service de pharmacologie clinique, institut de biologie, 9, quai Moncousu, 44093 Nantes cedex 1, France; EA 4275 « biostatistique, recherche clinique et mesures subjectives en santé », UFR de pharmacie, 1, rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France.
authors: E
authors: E
authors: Péron
authors: CEIP-addictovigilance, service de pharmacologie clinique, institut de biologie, 9, quai Moncousu, 44093 Nantes cedex 1, France; EA 4275 « biostatistique, recherche clinique et mesures subjectives en santé », UFR de pharmacie, 1, rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France.
authors: C
authors: C
authors: Bétaud
authors: CEIP-addictovigilance, service de pharmacologie clinique, institut de biologie, 9, quai Moncousu, 44093 Nantes cedex 1, France; EA 4275 « biostatistique, recherche clinique et mesures subjectives en santé », UFR de pharmacie, 1, rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France.
authors: P
authors: P
authors: Jolliet
authors: Service universitaire de psychiatrie de l'enfant et de l'adolescent, hôpital Mère-Enfant, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: M
authors: M
authors: Amar
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D063487:Prescription Drug Misuse / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate