Meta-analysis: Dose-Dependent Effects of Methylphenidate on Neurocognitive Functioning in Children With Attention-Deficit/Hyperactivity Disorder

Abstract

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Assessing therapeutic response to methylphenidate among children and adolescents with Attention-Deficit Hyperactivity Disorder: Narrative Review of its effects on emotional regulation, executive functions, and quality of life

“…c h i l d r e n a n d a d o l e s c e n t s w i t h A D H D Methylphenidate's effects have shown to be significant in terms of symptom reduction (e.g., Correll et al, 2021; Large effect size) and ER improvement by reducing overt and covert dysregulated behaviors (e.g., Pringshein et al, 2015; moderate to large effect sizes). When examining methylphenidate's effects on EFs as a unitary construct, they range from low to medium (e.g., Correll et al, 2021): Methylphenidate's effects on working memory updating producing a low effect size (e.g., , its effects on inhibitory control range from low to moderate with the majority producing a low effect size (e.g., Lee et al, 2022), and its effects on cognitive flexibility have been evaluated to be significant with a moderate effect size (e.g., Vertessen et al, 2021). Finally, methylphenidate's effects on QoL are significant with a marked improvement in QoL measures (Moderate to large effect sizes, e.g., Correll et al, 2021;Storebø et al, 2015;Tsujii et al, 2020).…”

“…Recently, methylphenidate's effects on EFs in children and adolescents with ADHD have been evaluated in five systematic and meta-analytic reviews Lee et al, 2022;Mckenzie et al, 2022;Tamminga et al, 2016;Vertessen et al, 2021). These reviews included studies that in their vast majority, were double blind placebo controlled randomized trials with participants between the ages of 5 and 18 that examined, among other cognitive functions, working memory updating, inhibitory control, and cognitive flexibility.…”

“…For instance, a meta-analysis that investigated the dose effects of methylphenidate on neurocognitive functions in children and adolescents with ADHD, found that, among the 6 core studies that reviewed cognitive flexibility (n = 213), methylphenidate improved its function with a relatively moderate effect size (SMD = 0.62) and no significant effect of the dose given, whether low (0.10-0.30 mg/kg) or medium (0.31-0.60 mg/kg). Though, not enough data has been gathered to determine high dose (0.61 -1.00 mg/kg) effects on cognitive flexibility (Vertessen et al, 2021).…”

Desvelando os efeitos adversos do metilfenidato na atenção infanto-juvenil

“…É importante que esse grupo populacional ao iniciar o uso de Metilfenidato tenham um acompanhamento e acesso direto aos profissionais de saúde na eminência de qualquer efeito adverso, uma vez, que a associação temporal direta indica que o medicamento poderia ser um potencial gatilho para desencadear infarto em pacientes com alguma predisposição 26. Infere-se que, é extremamente importante que a equipe multidisciplinar reconheça as etapas do processo de desenvolvimento infantil, principalmente no que se refere às mudanças corporais para que em conjunto com os familiares acompanhem seu desenvolvimento 25 . Orientação semelhante ao do estudo de revisão sistemática e meta-análise em que os dados destacam a importância de considerar os aspectos neurocognitivos e principalmente sintomáticos do TDAH na prática clínica 30 .…”

The effect of stimulant medication on the learning of academic curricula in children with ADHD: A randomized crossover study.

“…A primary purpose of attending school is to acquire skills such as reading and numerical operations and content knowledge in areas such as science and social studies. Many studies have shown that stimulants improve cognitive functioning on laboratory tasks (Coghill et al, 2014; Pietrzak et al, 2006; Rapport & Kelly, 1991; Swanson et al, 2011; Vertessen et al, 2021) and academic seatwork productivity in analog classrooms (Fabiano et al, 2007; Kortekaas-Rijlaarsdam et al, 2019; Pelham et al, 1985; Prasad et al, 2013). Children complete more seatwork and spend more time on task when medicated.…”