Evidence map›Paper›PMID 34283391›Full record

ArticleCNS drugs2021

Treatment with Methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) and the Risk of All-Cause Poisoning in Children and Adolescents: A Self-Controlled Case Series Study.

Le Gao, Kenneth K C Man, Esther W Chan, Celine S L Chui, Xue Li, David Coghill, Kam Lun Hon, Man Li Tse, Terry Y S Lum, Kirstie H T W Wong and 2 more

Open access · hybridAbstract read
In one paragraph

Article in CNS drugs, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 4 countries.

Le Gao *Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F Laboratory Block, 21 Sassoon Road, Hong Kong, China.ORCID http://orcid.org/0000-0002-9349-6599
Kenneth K C Man *Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F Laboratory Block, 21 Sassoon Road, Hong Kong, China.ORCID http://orcid.org/0000-0001-8645-1942
Esther W ChanDepartment of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F Laboratory Block, 21 Sassoon Road, Hong Kong, China.ORCID http://orcid.org/0000-0002-7602-9470
Celine S L ChuiSchool of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0003-1513-8726
Xue LiDepartment of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F Laboratory Block, 21 Sassoon Road, Hong Kong, China.ORCID http://orcid.org/0000-0003-4836-7808
David CoghillDepartments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0003-3017-9737
Kam Lun HonDepartment of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0002-6682-5529
Man Li TseHong Kong Poison Information Centre, United Christian Hospital, Hong Kong, China.ORCID http://orcid.org/0000-0003-2456-409X
Terry Y S LumDepartment of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0003-1196-5345
Kirstie H T W WongDepartment of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0003-4374-490X
Patrick IpDepartment of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0002-6797-6898
Ian C K WongDepartment of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F Laboratory Block, 21 Sassoon Road, Hong Kong, China. wongick@hku.hk.ORCID http://orcid.org/0000-0001-8242-0014
University of Hong Kong · HKChinese University of Hong Kong · HKHKU-Pasteur Research Pole · HKThe University of Melbourne · AUUnited Christian Hospital · CNUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren and adolescents with attention deficit hyperactivity disorder (ADHD) are at higher risk of all-cause poisoning by drugs and chemicals (intentional or accidental). Currently, there is limited data on whether medication treatment for ADHD can reduce the risk of all-cause poisoning.

methodsPatients aged 5-18 years with a methylphenidate (MPH) prescription and an incident poisoning diagnosis between January 2001 and June 2020 were identified from the Hong Kong Clinical Data Analysis and Reporting System. A self-controlled case series study design was used to compare the incidence rate ratios (IRRs) of all-cause poisoning during different risk windows (30 days before the first MPH prescription, exposure periods within 30 days of the first prescription, and periods of subsequent exposure) compared with the reference window (other non-exposure periods).

results42,203 patients were prescribed ADHD medication in Hong Kong during the study period. Of these, 417 patients who had both an MPH prescription and poisoning incident recorded were included in the main analysis. Compared with other non-exposed periods, a higher risk of poisoning was found in the 30 days before the first prescription (IRR 2.64, 95% confidence interval [CI] 1.33-5.22) and exposure periods within 30 days of the first prescription (IRR 2.18, 95% CI 1.06-4.48), but not during prolonged exposure. However, compared with 30 days before the first prescription as well as exposure periods within 30 days of the first prescription, there was a lower risk during the subsequent exposure (IRRs 0.49 and 0.60, respectively). Similar results to the main analysis were also found in the subgroup analysis of intentional poisoning and females, but not in that of accidental poisoning and males.

conclusionsThe risk of all-cause poisoning was higher shortly before and after the first MPH prescription and became lower during the subsequent prescription period. Our results do not support an association between the use of MPH and an increased risk of all-cause poisoning in children and adolescents and, in fact, suggest that longer-term use of MPH may be associated with a lower risk of all-cause poisoning, although this latter finding requires further study.

Indexed as

Attention Deficit Disorder with HyperactivityMethylphenidatePoisoningAdolescentCentral Nervous System StimulantsChildFemaleHong KongHumansIncidenceMaleMedication Therapy ManagementRisk AdjustmentRisk AssessmentRisk FactorsCentral Nervous System StimulantsMethylphenidate

Identifiers

PMID34283391
PMCPMC8310501
OpenAlexW3184786411

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.