title: Methylphenidate for ADHD in children and adolescents: throwing the baby out with the bathwater.
abstract: A recent Cochrane review assessed the efficacy of methylphenidate for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Notwithstanding the moderate-to-large effect sizes for ADHD symptom reduction found in the meta-analysis, the authors concluded that the quality of the evidence is low and therefore the true magnitude of these effects remains uncertain. We identified a number of major concerns with the review, in the domains of study inclusion, approaches to quality assessment and interpretation of data relating to serious adverse events as well as of the clinical implications of the reported effects. We also found errors in the extraction of data used to estimate the effect size of the primary outcome. Considering all the shortcomings, the conclusion in the Cochrane review that the status of the evidence is uncertain is misplaced. Professionals, parents and patients should refer to previous reviews and existing guidelines, which include methylphenidate as one of the safe and efficacious treatment strategies for ADHD.
authors.affiliation: Department of Child Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Banaschewski
authors.affiliation: Department of Cognitive Neuroscience, Donders Institute of Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.|Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Buitelaar
authors.affiliation: Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, China.
authors.forename: Celine S L
authors.initials: CS
authors.lastname: Chui
authors.affiliation: Department of Paediatrics and Psychiatry Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Coghill
authors.affiliation: Department of Psychology, University of Southampton, Southampton, UK.|Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, UK.
authors.forename: Samuele
authors.initials: S
authors.lastname: Cortese
authors.affiliation: Department of Psychology, University of Southampton, Southampton, UK.|Department of Child & Adolescent Psychiatry, King's College London, Institute of Psychiatry Psychology & Neuroscience, London, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Simonoff
authors.affiliation: Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, China.|Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000139:chemically induced*; D002648:Child; D006801:Humans; D008774:Methylphenidate; D010290:Parents; D016896:Treatment Outcome; D035501:Uncertainty
chemical_list: D008774:Methylphenidate