ReviewScandinavian journal of child and adolescent psychiatry and psychology2018
Hallucinations and other psychotic symptoms in response to methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder: a Cochrane systematic review with meta-analysis and trial sequential analysis
Review in Scandinavian journal of child and adolescent psychiatry and psychology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- 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
- Investigating Potential Adverse Drug Reactions of Lisdexamfetamine Using Sequence Symmetry Analysis.Basic & clinical pharmacology & toxicology · 2026Article
- Methylphenidate Treatment and Risk of Psychotic Disorder.JAMA psychiatry · 2026Article
- Prescription psychostimulants, atomoxetine and the risk of psychosis in adults with history of psychosis: a population-based cohort study.Translational psychiatry · 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
- Gut-Brain Inflammatory Pathways in Attention-Deficit/Hyperactivity Disorder: The Role and Therapeutic Potential of Diet.Metabolites · 2025Review
- Psychosis with use of amphetamine drugs, methylphenidate and atomoxetine in adolescent and adults.BMJ mental health · 2024Article
- Comparison of the real-world safety of two different long-acting methylphenidate formulations (MedikinetScandinavian journal of child and adolescent psychiatry and psychology · 2024Article
- The Adverse Effects and Nonmedical Use of Methylphenidate Before and After the Outbreak of COVID-19: Machine Learning Analysis.Journal of medical Internet research · 2023Article
- Psychosis Induced by Methylphenidate in Children and Young Patients With Attention-Deficit Hyperactivity Disorder.Cureus · 2023Review
- Does Methylphenidate Work in Children and Adolescents with Attention Deficit Hyperactivity Disorder?Pediatric reports · 2021Article
- Methylphenidate and the risk of psychosis in adolescents and young adults: a population-based cohort study.The lancet. Psychiatry · 2019Observational
- Occurrence of psychotic symptoms during treatment of ADHD with methylphenidate: Clinical significance and the need for further research.Scandinavian journal of child and adolescent psychiatry and psychology · 2018Article
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is little evidence in the literature on the association between methylphenidate treatment and psychotic symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).
objectiveWe examine the occurrence of psychotic symptoms during methylphenidate treatment of children and adolescents with ADHD. The data arise from our two Cochrane systematic reviews on methylphenidate, reported elsewhere.
methodsElectronic databases were searched up to January 2016 (for observational studies) and March 2017 (for randomized trials). We summarized data as risk ratios and pooled prevalences. Trial Sequential Analysis was used to control for random errors. We assessed the risk of bias and the quality of evidence according to Cochrane guidelines.
resultsTen randomized trials (1103 participants), 17 non-randomized studies (76,237 participants) and 12 patient reports or series (18 patients) were identified. In the randomized trials, there was no significant difference in the risk of developing psychotic symptoms [10 of 654 (pooled prevalence, 2.5%) methylphenidate versus 1 of 508 (pooled prevalence, 1.7%) placebo patients; risk ratio, 2.07; 95% confidence interval, 0.58 to 7.35]. Nine of 10 trials had a high risk of bias, and according to the Trial Sequential Analysis, the required information size was not achieved, that is, the meta-analysis was considerably underpowered. There were 873 instances of psychotic symptoms in the non-randomized studies among 55,603 participants (pooled prevalence, 1.2%; 95% confidence interval, 0.7 to 2.4). In the comparative cohort study, methylphenidate significantly increased the risk for any psychotic disorder by 36% (risk ratio, 1.36; 95% confidence interval, 1.17 to 1.57). The overall risk of bias was rated as critical for this study.
conclusionsBecause of sparse data and low quality of evidence, we cannot confirm or refute whether methylphenidate increases the risk of psychotic symptoms in children and adolescents with ADHD. This possible adverse event may affect 1.1% to 2.5%, and physicians, patients and caregivers should be aware of this to ensure proper treatment in case of occurrence during methylphenidate treatment.
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