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Association Between Tic Aggravation and Methylphenidate in Youth With Attention-Deficit/Hyperactivity Disorder.

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  • 1Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

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|September 9, 2021
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Summary

Methylphenidate (MPH) treatment for attention-deficit/hyperactivity disorder (ADHD) shows a low tic aggravation rate, especially in patients without a prior tic history. Close monitoring is advised during the initial treatment phase.

Keywords:
Attention-deficit/hyperactivity disorderCumulative incidenceMethylphenidateTic

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Area of Science:

  • Neuroscience
  • Pediatrics
  • Psychiatry

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
  • Methylphenidate (MPH) is a frequently prescribed stimulant medication for ADHD.
  • The potential for MPH to exacerbate tics is a clinical concern.

Purpose of the Study:

  • To determine the incidence of tic aggravation during MPH treatment in children and adolescents with ADHD.
  • To identify factors influencing tic aggravation.
  • To assess the cumulative incidence of tic aggravation.

Main Methods:

  • Retrospective chart review of 121 children and adolescents (6-15 years) diagnosed with ADHD.
  • Assessment of MPH dosage, psychiatric family history, comorbidities, and past tic history.
  • Statistical analysis using Cox regression and Kaplan-Meier survival analysis.

Main Results:

  • Tic aggravation occurred in 2.9% of patients without a prior tic history on MPH.
  • Past tic history, total MPH dosage, and age were significant factors associated with tic aggravation.
  • Tic aggravation typically appeared within the first six to eight months of MPH treatment.

Conclusions:

  • MPH treatment for ADHD is associated with a low rate of tic aggravation, particularly in patients without a history of tics.
  • A thorough assessment of past tic history is crucial before initiating MPH.
  • Close monitoring during the initial six to eight months of MPH treatment is recommended to manage potential tic worsening.