ADHD is one of the most common psychiatric diagnoses among children and adolescents worldwide.
The standard of care for ADHD typically includes long-term treatment with stimulants, such as methylphenidate (MPH)-based medications (e.g., Ritalin). Researchers in Israel studied the connection between children diagnosed with ADHD and prescribed MPH between the ages of six and eight, and future dispensed prescriptions of antidepressants.
Experts report a worldwide escalation in MPH-based medication prescriptions for ADHD over the last few decades, particularly among children and adolescents. As a result, the long-term effects of exposure to MPH have become a major public health interest, particularly given the high prevalence, long duration, and early age of MPH treatment onset.
Over the years, research has shown that taking MPH-based medications as prescribed, mostly during or after the onset of puberty, prevents depression and anxiety later on. In the new, 12-year longitudinal study, investigators monitored 6,830 children from early childhood into adolescence.
The study was conducted by researchers at Bar-Ilan University in Israel, together with physicians and psychiatrists from Clalit Health Services, the country’s largest healthcare organization, and the Geha Mental Health Center. It is the first of its kind to examine the connection between children diagnosed with ADHD and prescribed MPH between the ages of six and eight, and future prescriptions for antidepressants.
The research findings appear in the journal European Child and Adolescent Psychiatry.
Investigators sampled all children who were first prescribed with MPH-based medications between the ages of six and eight, and then recorded individual adherence by tracking how many months the medication was purchased in relation to the amount prescribed, until the age of 12.
They discovered children with high adherence (above 50 percent) were at significantly greater risk of being prescribed with antidepressants between the ages of 12-18, after controlling for individual risk factors, such as parental use of antidepressants (OR = 1.50).
“Parents, doctors and teachers should be aware that prolonged consumption of MPH-based medications beginning at these ages can be a predictor of subsequent use of antidepressants. Our findings highlight the importance of systematic follow-up for all children who initiated MPH treatment before the age of eight and persisted in their treatment,” said Dr. Nir Madjar, of Bar-Ilan University’s Churgin School of Education.
Investigators conclude that while greater adherence is likely associated with a greater beneficial effect on ADHD symptoms, the underlying emotional and behavioral dysregulation among symptomatic children may still be present during adolescence. This in turn may influence depression and the increase in antidepressant medications.
Source: Bar-Ilan University/EurekAlert