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ADHD scientists publicly raise doubts about the effects of Ritalin
For many years, drugs containing the active ingredient methylphenidate, such as the well-known "Ritalin", have become the standard treatment for attention-deficit hyperactivity disorder (ADHD). But whether they really help, is apparently hardly proven. Researchers from the Cochrane Collaboration have now come to this conclusion after having evaluated 185 studies involving more than 12,000 affected children and adolescents.
Methylphenidate is included in many preparations
The active ingredient methylphenidate has been used in children, adolescents and adults with ADHD for more than 50 years as part of the so-called "multimodal therapy". In the public in this context is usually the drug "Ritalin" the speech, but the psychostimulant methylphenidate is now included in a variety of different preparations. The fact that the active ingredient has been on the market for such a long time is considered by many physicians to be proof of its effectiveness and harmlessness. But this conclusion could be a bit premature. For the current analysis of the international research network "Cochrane Collaboration" now shows a different perspective: Accordingly, the study situation in the treatment of children and adolescents with methylphenidate is thin and have little meaning.
Ritalin: Hardly confirmed efficacy studies. Image: EinBlick - fotolia Experts analyze 185 studies
The Cochrane Collaboration unites scientists and research groups worldwide who evaluate the benefits and harms of therapies and early detection measures according to an internationally recognized, standardized procedure. For the current study, the experts analyzed 185 studies involving a total of 12,245 children and adolescents aged between three and 18 diagnosed with ADHD. In all studies, the efficacy of the drug methylphenidate was assessed by comparing it to a no-drug (placebo) or omission treatment, the statement from the network said.
Methylphenidate has been shown to relieve some of the core symptoms of ADHD such as hyperactivity, impulsivity and concentration problems. Likewise, the drug was able to improve the overall behavior and quality of life of the affected children, but at the same time also confirmed possible side effects such as sleep problems and loss of appetite, the Cochrane Collaboration continues.
Nearly 40 percent of the studies funded by the industry
But these results could not convince the researchers led by the Danish psychiatrist Ole Jakob Storebø. Because 72 of the 185 studies (40 percent) had been funded by the industry, they had to calculate that subjects may have known that they had e.g. just got a placebo. Accordingly, a possible falsification of the results could not be excluded, especially as the data in many studies were not complete.
The Cochrane researchers found that on average, the trials only covered a treatment period of 75 days (one to 425 days depending on the study), making it impossible to assess the long-term effects of the drug. "This analysis highlights the need for long-term, larger and better-quality randomized trials so we can more reliably determine the average effect of this drug," said Professor Ole Jakob Storebø in the Cochrane Collaboration Communication.
More accurate results are important for health professionals and parents
Because exactly this proof is important for health professionals and the parents of the affected children, complements co-author Dr. Morris Zwi. "Our expectations for this treatment are likely to be greater than they should be, and as there was some evidence of benefit during our review, we should not forget that this finding is based on very poor evidence," Dr. Morris Zwi. Accordingly, it would need further well-conducted studies to clarify the benefits and risks of this widespread treatment.
Treatment must be accompanied carefully
Co-author Camilla Groth therefore urged physicians to consider the poor evidence of prescribing psychostimulants, to carefully weigh the benefits and side effects, and to carefully monitor the treatment. "This review provides very limited evidence of the effects of methylphenidate in children and adolescents with ADHD. Some may benefit, but we do not know yet which patients they are, "says Groth.
However, in view of the results should not be overreacted by the drugs are now discontinued immediately, so the warning of Cochrane researchers. "If treatment in a child or adolescent brings benefits without adverse effects, then the conditions may be met to continue treatment. Patients and their parents should always discuss any decision to stop treatment with their doctor before acting, "Dr. Zwi added. (No)