The quality of evidence for methylphenidate as reported in the Nordic clinical practice guidelines (CPGs) on pediatric ADHD (i_e_ for children ≥ 6 years-of-age)_
| CPG by country of origin (year of CPG publication/update) | Benefits | Harms |
|---|---|---|
| Denmark14 (2021) | Based on the randomized trials reviewed, a good effect was found on both ADHD core symptoms and behavioral difficulties, as reported by teachers, parents, and observers/clinicians. (Quality of evidence: B) | No significantly higher number of serious adverse effects was reported, but this estimate is very uncertain (Quality of evidence: D). |
| Finland13 (2025) | Methylphenidate significantly reduces inattention, impulsivity, and hyperactivity symptoms of ADHD in children and adolescents, at least in short-term (less than six months) treatment (Quality of evidence: A) | Side effects of methylphenidate are common but usually mild in the short-term treatment of ADHD in children and adolescents (Quality of evidence: A). |
| Treatment of ADHD with methylphenidate does not apparently increase the risk of serious cardiovascular adverse effects (Quality of evidence: B). | ||
| Island15 (2023) | NA | NA |
| Norway16 (2022) | A large number of controlled studies have documented that treatment with methylphenidate containing medications results in a significant reduction of symptoms (such as difficulties with concentration, hyperactivity, and impulsivity) in 70–80% of children and adolescents with ADHD/Hyperkinetic disorder (Quality of evidence: A) | NA |
| Sweden17 (2024) | For up to 1 year methylphenidate reduces core ADHD symptoms in children and adolescents more than placebo (SMD − 0,78; 95% CI −0,93 −0,62) (Quality of evidence: B). | It is unclear whether methylphenidate affects treatment discontinuation due to side effects in children and adolescents (Quality of evidence: D). |
| Methylphenidate improves functioning in children and adolescents with ADHD more than placebo, as evaluated with the WFIRS-P (mean difference −0.25; 95% CI −0.35 to −0.15) (Quality of evidence: C). | Methylphenidate increases systolic blood pressure more than placebo in children and adolescents (SMD 0.15; 95% CI 0.05 to 0.25) (Quality of evidence: B) | |
| It is unclear whether methylphenidate has an effect on functioning in children and adolescents with ADHD when evaluated using the BSFQ, SCS, PREMB-R AM, or PM tools, as well as academic performance (various domains of reading, spelling, and mathematics) (Quality of evidence: D). | Methylphenidate increases diastolic blood pressure more than placebo in children and adolescents (SMD 0.27; 95% CI 0.17 to 0.38) (Quality of evidence: B). | |
| It is unclear whether methylphenidate affects the frequency of sudden death/ventricular arrhythmia or mortality (all causes) in children and adolescents (Quality of evidence: D). | ||
| It is unclear whether treatment with methylphenidate affects quality of life in children and adolescents with ADHD (Quality of evidence: D). | There are no studies to assess whether methylphenidate affects the frequency of myocardial infarction or stroke in children (≥ 6 years). |