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Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long‐term use: a randomized, placebo‐controlled discontinuation study.

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Title: Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long‐term use: a randomized, placebo‐controlled discontinuation study.
Authors: Rosenau, Paul T., Openneer, Thaïra J. C., Matthijssen, Anne‐Flore M., van de Loo‐Neus, Gigi H. H., Buitelaar, Jan K., van den Hoofdakker, Barbara J., Hoekstra, Pieter J., Dietrich, Andrea
Source: Journal of Child Psychology & Psychiatry. Dec2021, Vol. 62 Issue 12, p1444-1452. 9p. 1 Diagram, 3 Charts.
Subjects: Executive function, Drug efficacy, Memory, Methylphenidate, Psychology of movement, Task performance, Attention-deficit hyperactivity disorder, Randomized controlled trials, Neuropsychological tests, Blind experiment, Attention, Drug utilization, Statistical sampling, Reaction time, Pharmacodynamics, Evaluation, Children, Adolescence
Geographic Terms: Netherlands
Abstract: Background: Methylphenidate may improve executive functioning in children with attention‐deficit/hyperactivity disorder (ADHD). However, it is unclear if there are still acute effects of methylphenidate on executive functioning after long‐term use. Methods: In a randomized double‐blind, placebo‐controlled discontinuation study, 94 children and adolescents (ages 8–18 years) who used methylphenidate beyond two years were either assigned to seven weeks of continued treatment with 36 or 54 mg of extended‐release methylphenidate or to gradual withdrawal over three weeks to placebo for four weeks. Performance on neuropsychological tasks, measuring working memory, response inhibition, attentional flexibility and psychomotor speed was compared between both groups using mixed models for repeated measures. Additionally, we investigated within the discontinuation group if a deterioration on the investigator‐rated Clinical Global Impressions Improvement scale after withdrawing to placebo was related to a worse performance on the neuropsychological tasks. This study was registered in the Netherlands Trial Register (www. Trialregister.nl) with identifier 5252. Results: After withdrawal of methylphenidate, the discontinuation group made more errors on working memory (β = −1.62, SD = 0.56, t = −2.88, p =.01, Cohen's f2 =.14), independent from reaction time compared to baseline, in contrast to the continuation group. We did not find differences in changes in response inhibition, attentional flexibility and psychomotor speed between the two groups. Also, there were no significant differences in task measures between the participants who deteriorated clinically and those who did not. Conclusions: Our study shows that methylphenidate has a beneficial effect on working memory after two years of use. Future studies should explore whether cognitive outcomes may aid clinical decision‐making on the continued use of methylphenidate, given dissociation between cognitive and behavioural effects of stimulant medication. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long‐term use: a randomized, placebo‐controlled discontinuation study.
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  Data: <searchLink fieldCode="AR" term="%22Rosenau%2C+Paul+T%2E%22">Rosenau, Paul T.</searchLink><br /><searchLink fieldCode="AR" term="%22Openneer%2C+Thaïra+J%2E+C%2E%22">Openneer, Thaïra J. C.</searchLink><br /><searchLink fieldCode="AR" term="%22Matthijssen%2C+Anne‐Flore+M%2E%22">Matthijssen, Anne‐Flore M.</searchLink><br /><searchLink fieldCode="AR" term="%22van+de+Loo‐Neus%2C+Gigi+H%2E+H%2E%22">van de Loo‐Neus, Gigi H. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Buitelaar%2C+Jan+K%2E%22">Buitelaar, Jan K.</searchLink><br /><searchLink fieldCode="AR" term="%22van+den+Hoofdakker%2C+Barbara+J%2E%22">van den Hoofdakker, Barbara J.</searchLink><br /><searchLink fieldCode="AR" term="%22Hoekstra%2C+Pieter+J%2E%22">Hoekstra, Pieter J.</searchLink><br /><searchLink fieldCode="AR" term="%22Dietrich%2C+Andrea%22">Dietrich, Andrea</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Child+Psychology+%26+Psychiatry%22">Journal of Child Psychology & Psychiatry</searchLink>. Dec2021, Vol. 62 Issue 12, p1444-1452. 9p. 1 Diagram, 3 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Executive+function%22">Executive function</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+efficacy%22">Drug efficacy</searchLink><br /><searchLink fieldCode="DE" term="%22Memory%22">Memory</searchLink><br /><searchLink fieldCode="DE" term="%22Methylphenidate%22">Methylphenidate</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+movement%22">Psychology of movement</searchLink><br /><searchLink fieldCode="DE" term="%22Task+performance%22">Task performance</searchLink><br /><searchLink fieldCode="DE" term="%22Attention-deficit+hyperactivity+disorder%22">Attention-deficit hyperactivity disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychological+tests%22">Neuropsychological tests</searchLink><br /><searchLink fieldCode="DE" term="%22Blind+experiment%22">Blind experiment</searchLink><br /><searchLink fieldCode="DE" term="%22Attention%22">Attention</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+utilization%22">Drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Reaction+time%22">Reaction time</searchLink><br /><searchLink fieldCode="DE" term="%22Pharmacodynamics%22">Pharmacodynamics</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation%22">Evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescence%22">Adolescence</searchLink>
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  Data: Background: Methylphenidate may improve executive functioning in children with attention‐deficit/hyperactivity disorder (ADHD). However, it is unclear if there are still acute effects of methylphenidate on executive functioning after long‐term use. Methods: In a randomized double‐blind, placebo‐controlled discontinuation study, 94 children and adolescents (ages 8–18 years) who used methylphenidate beyond two years were either assigned to seven weeks of continued treatment with 36 or 54 mg of extended‐release methylphenidate or to gradual withdrawal over three weeks to placebo for four weeks. Performance on neuropsychological tasks, measuring working memory, response inhibition, attentional flexibility and psychomotor speed was compared between both groups using mixed models for repeated measures. Additionally, we investigated within the discontinuation group if a deterioration on the investigator‐rated Clinical Global Impressions Improvement scale after withdrawing to placebo was related to a worse performance on the neuropsychological tasks. This study was registered in the Netherlands Trial Register (www. Trialregister.nl) with identifier 5252. Results: After withdrawal of methylphenidate, the discontinuation group made more errors on working memory (β = −1.62, SD = 0.56, t = −2.88, p =.01, Cohen's f2 =.14), independent from reaction time compared to baseline, in contrast to the continuation group. We did not find differences in changes in response inhibition, attentional flexibility and psychomotor speed between the two groups. Also, there were no significant differences in task measures between the participants who deteriorated clinically and those who did not. Conclusions: Our study shows that methylphenidate has a beneficial effect on working memory after two years of use. Future studies should explore whether cognitive outcomes may aid clinical decision‐making on the continued use of methylphenidate, given dissociation between cognitive and behavioural effects of stimulant medication. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1111/jcpp.13419
    Languages:
      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 1444
    Subjects:
      – SubjectFull: Executive function
        Type: general
      – SubjectFull: Drug efficacy
        Type: general
      – SubjectFull: Memory
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      – SubjectFull: Methylphenidate
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      – SubjectFull: Psychology of movement
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      – SubjectFull: Task performance
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      – SubjectFull: Attention-deficit hyperactivity disorder
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      – SubjectFull: Randomized controlled trials
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      – SubjectFull: Neuropsychological tests
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      – SubjectFull: Attention
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      – SubjectFull: Reaction time
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      – SubjectFull: Pharmacodynamics
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      – SubjectFull: Evaluation
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      – SubjectFull: Children
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      – SubjectFull: Adolescence
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      – SubjectFull: Netherlands
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      – TitleFull: Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long‐term use: a randomized, placebo‐controlled discontinuation study.
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              Text: Dec2021
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