Are stimulants addictive in children? What the evidence says

Prescription stimulants are widely used to treat attention deficit hyperactivity disorder in clinical practice.

A systematic review of the literature was performed to assess available evidence regarding the propensity for abuse and addiction liability of these medications.

Trials were searched in computerised general databases (Medline, Psychlit and Embase) and specialised (Cochrane Controlled Trials Register, Cochrane Collaboration); by checking reference lists of relevant articles; by handsearching relevant specialist journals; and by contacting relevant authors where appropriate. Publications in all languages were sought. Studies had to have sufficient description of study methodology and statistical analysis to permit critical evaluation. Randomised controlled clinical trials, crossover studies, cohort studies and case control studies were included. Human studies only were considered for inclusion.

Sixty-eight trials were located using the specified search strategy. Of these, fifteen trials met inclusion criteria: five randomised controlled trials; nine crossover studies and one cohort study. The propensity for abuse of prescription stimulants was demonstrated by analysis of drug self administration, discriminatory ability and comparison studies. Insufficient evidence was available regarding the addiction liability of stimulants.

Prescription stimulants have the propensity for abuse. There is insufficient evidence available to assess their addictive potential.