ArticleBMJ (Clinical research ed.)2016
Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self controlled case series study.
Article in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 52 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 6 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Association of ADHD medications with the risk of cardiovascular diseases: a meta-analysis.European child & adolescent psychiatry · 2019Pooled it
- The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression.International journal of environmental research and public health · 2018Pooled it
- Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies.The Cochrane database of systematic reviews · 2018Pooled it
- Pooled it
- Cardiovascular Implications of the Enhanced Games: Performance Enhancing Drugs in Competition and Recreation.Sports medicine - open · 2026Review
- Use of methylphenidate and the risk of cardiovascular diseases in children and adolescents with a family history of heart diseases and congenital heart diseases: A self-controlled case series study.European child & adolescent psychiatry · 2026Article
- ADHD and Methylphenidate Use in Prepubertal Children and BMI and Height at Adulthood.JAMA network open · 2026Article
- Disproportionality analysis of methylphenidate-associated adverse events in pediatric patients using the FDA Adverse Event Reporting System: overall signals and stratification by gender and dosage form.Frontiers in psychiatry · 2026Article
- Children and Young Adults Who Used Medication for Attention Deficit Hyperactivity Disorder Faced Increased Cardiac Risks.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Cerebrovascular diseases in ADHD patients with metabolic comorbidities: a retrospective cohort study.BMC psychiatry · 2025Article
- ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials.BMJ (Clinical research ed.) · 2025Article
- Incidence and trend of cardiac events among children and young adults exposed to psychopharmacological treatment (2006-2018): A nationwide register-based study.British journal of clinical pharmacology · 2025Article
- Association between methylphenidate use and long-term cardiovascular risk in paediatric patients with attention deficit and hyperactivity disorder.BMJ paediatrics open · 2024Article
- Outcomes from Individual Alpha Frequency Guided Repetitive Transcranial Magnetic Stimulation in Children with Autism Spectrum Disorder - A Retrospective Chart Review.Child psychiatry and human development · 2024Article
- Methylphenidate and Short-Term Cardiovascular Risk.JAMA network open · 2024Article
- Methylphenidate-Induced Non-ischemic Heart Failure With Reduced Ejection Fraction and Mild Pulmonary Hypertension.Cureus · 2024Article
- Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases.JAMA psychiatry · 2024Article
- Methylphenidate-associated chest pain in a child.BMJ case reports · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether treatment with methylphenidate in children and young people with attention-deficit/hyperactivity disorder (ADHD) was associated with cardiovascular events.
designSelf controlled case series analysis.
settingNationwide health insurance database, 1 January 2008 to 31 December 2011, in South Korea.
participants1224 patients aged ≤17 who had experienced an incident cardiovascular event and had had at least one incident prescription for methylphenidate.
main outcome measuresA recorded diagnosis (either a primary or secondary cause) of any of the following cardiovascular adverse events: arrhythmias (ICD-10 (international classification of diseases, 10th revision) codes I44, I45, I47, I48, I49), hypertension (codes I10-I15), myocardial infarction (code I21), ischemic stroke (code I63), or heart failure (code I50). Incidence rate ratios were calculated with conditional Poisson regression and adjusted for time varying comorbidity and comedication.
resultsIncreased risk of arrhythmia was observed in all exposed time periods-that is, periods of treatment with methylphenidate-(incidence rate ratio 1.61, 95% confidence interval 1.48 to 1.74), and the risk was highest in the children who had congenital heart disease. No significant risk of myocardial infarction was observed for all exposed time periods (1.33, 0.90 to 1.98), though risk was higher in the early risk periods between eight and 56 days after the start of treatment with methylphenidate. No significant increased risk was observed for hypertension, ischemic stroke, or heart failure.
conclusionThe relative risk of myocardial infarction and arrhythmias is increased in the early period after the start of methylphenidate treatment for ADHD in children and young people. Though the absolute risk is likely to be low, the risk-benefit balance of methylphenidate should be carefully considered, particularly in children with mild ADHD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.