The Jury Is Still Out on the Benefits and Harms of Methylphenidate for Children and Adolescents With Attention‐Deficit/Hyperactivity Disorder

Storebø, Ole Jakob; Faltinsen, Erlend; Zwi, Morris; Simonsen, Erik; Gluud, Christian

doi:10.1002/cpt.1149

Cited by 22 publications

(28 citation statements)

References 10 publications

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“…The administration of common ADHD medica-Do food bioactives play a role in attention-deficit/hyperactivity disorder? Lange tions may be associated with various adverse effects as serious as growth retardation and severe cardiovascular events (Lange, 2017a(Lange, , 2018aStorebø et al, 2018;Swanson et al, 2017). The present state of information based on randomized controlled trials may indicate that pharmacotherapy for ADHD should be administered with caution or even discontinued after a period of 12 weeks (Lange, 2018a) and alternative treatment strategies should be explored.…”

Section: Introductionmentioning

confidence: 99%

Do food bioactives play a role in attention-deficit/hyperactivity disorder?

Lange¹

2018

Journal of Food Bioactives

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Attention-deficit/hyperactivity disorder (ADHD) is a common diagnosis in children, which may persist into adulthood. Short-term benefits of pharmacological treatment have been shown, but concerns regarding long-term efficacy and safety have led to a search for alternative treatments. Nutrition may be an important factor in psychiatric disorders. At group level, food bioactives do not appear to play a significant pathogenetic or therapeutic role in ADHD. Benefits of treatment with omega-3 fatty acids, vitamins and minerals may be confined to individuals deficient in these micronutrients. Dietary patterns may be of greater importance than individual nutrients. However, both diet and consumption of certain nutrients may be precursors or consequences of ADHD. The controversy surrounding the clinical and pathogenetic heterogeneity of ADHD complicates the assessment of food bioactives. The identification of a potential role of food bioactives in ADHD is hindered by the ill-defined nature of the disorder and the lack of biological markers underpinning its validity. The therapeutic efficacy of food bioactives cannot be tested by evaluating their effect on the pathophysiology of ADHD but only by observing their effects on symptom severity.

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Section: Introductionmentioning

confidence: 99%

Do food bioactives play a role in attention-deficit/hyperactivity disorder?

Lange¹

2018

Journal of Food Bioactives

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“…Recent guidelines (see http://www.nice.org) recommend methylphenidate as the first‐line pharmacological treatment for children and adolescents with ADHD. Storebø et al . summarized two reviews of methylphenidate on the basis of methods of the Cochrane Collaboration (http://www.cochrane.org) and questioned the strength of this recommendation.…”

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confidence: 99%

“…Because of the brevity of the summary, Storebø et al . were not able to provide details, but they did mention additional findings from these reviews on the basis of assessments of risk of bias and quality of evidence.…”

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confidence: 99%

“…were not able to provide details, but they did mention additional findings from these reviews on the basis of assessments of risk of bias and quality of evidence. For the review of randomized controlled trials, they state “… all included trials were assessed as being at high risk of bias [and] evidence certainty was rated as being ‘very low’”, and for the review of nonrandomized trials, they state “… All outcomes had low quality of evidence.” The perceived uncertainty about the estimates of benefits and harms led Storebø et al . to suggest (in the title) that “… the jury is still out on the benefits and harms of methylphenidate for children and adolescents with ADHD.” This conclusion is likely to be controversial.…”

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confidence: 99%

“…The brief and concise summary provided by Storebø et al . did not discuss the controversy and debate that ensued after the publication of the first review .…”

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See 2 more Smart Citations

Risk of Bias and Quality of Evidence for Treatment of ADHD With Stimulant Medication

Swanson

2018

Clin Pharma and Therapeutics

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Storebø et al. provide a concise summary of two Cochrane reviews about benefits and harms of treatment of attention-deficit/hyperactivity disorder (ADHD) with methylphenidate: (1) a review of 185 randomized controlled trials that estimated benefits (e.g., moderate-to-large reduction in teacher-rated ADHD symptoms) and (2) a review of 260 nonrandomized trials that estimated harms (e.g., infrequent serious but frequent nonserious adverse events). They also mention (without providing much detail) additional information from the structured Cochrane method about the risk for bias in the trials reviewed (assessed as being high) and quality of evidence of the outcomes considered (rated as being very low). This led to the conclusion that "the jury is still out on benefits and harms." A similar conclusion of the first review generated an extensive debate in the literature. Some details will be summarized and discussed herein to provide context in case the recent review and the summary by Storebø et al. revive the debate.

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Lipids in the Treatment of Mental Disorders

Lange

2020

Bailey's Industrial Oil and Fat Products

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The management of mental disorders is dominated today by pharmacotherapy, while nutrition and dietary approaches play a minor role. Evidence from both preclinical and clinical investigations suggests an important role for lipids in major mental disorders. Alterations in the concentration, organization, and metabolism of lipids are associated with mood disorders, schizophrenia, and behavioral problems in childhood. The lipid composition of the brain can be influenced by nutrition, environmental factors, and behavioral activity. Lipids, and omega‐3 polyunsaturated fatty acids (PUFAs) in particular, may represent a target for the prevention and treatment of mental disorders. Deficits in the dietary omega‐3 PUFAs, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been implicated in the pathophysiology of several mental disorders and linked to the maintenance of brain health. This may be mediated by the modulation of inflammatory processes and direct effects on neuronal membrane fluidity and receptor function. Low levels of omega‐3 PUFAs have been associated with various mental disorders, such as poor cognition, depression, anxiety disorders, schizophrenia, and attention‐deficit/hyperactivity disorder (ADHD). The available findings from randomized clinical trials examining the therapeutic efficacy of omega‐3 PUFAs are inconsistent and inconclusive. This limits their usage in psychiatric practice. Future research should investigate the molecular mechanisms underlying the effects of omega‐3 PUFAs in mental disorders. Large‐scale, well‐designed clinical trials should be conducted to assess the efficacy of omega‐3 PUFAs in the prevention and therapy of various mental disorders.

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The Jury Is Still Out on the Benefits and Harms of Methylphenidate for Children and Adolescents With Attention‐Deficit/Hyperactivity Disorder

Cited by 22 publications

References 10 publications

Do food bioactives play a role in attention-deficit/hyperactivity disorder?

Do food bioactives play a role in attention-deficit/hyperactivity disorder?

Risk of Bias and Quality of Evidence for Treatment of ADHD With Stimulant Medication

Lipids in the Treatment of Mental Disorders

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