Children with high adherence to methylphenidate-based medications for the treatment of attention-deficit/hyperactivity disorder (ADHD) are significantly more likely to be prescribed antidepressants during adolescence, according to a study published online in European Child & Adolescent Psychiatry.
The 12-year prospective cohort study spanned 6830 young patients with ADHD in Israel. Researchers included children first prescribed methylphenidate between the ages of 6 and 8 and gauged adherence through age 12 by tracking how many months the prescribed medication was purchased.
Children with high adherence, researchers reported, had a 50% higher likelihood of receiving antidepressant prescriptions between the ages of 12 and 18, after controlling for other comorbid psychiatric conditions as well as parental use of antidepressants.
“Parents, doctors, and teachers should be aware that prolonged consumption of methylphenidate-based medications beginning at these ages can be a predictor of subsequent use of antidepressants,” said study leader Nir Madjar, PhD, of Bar-Ilan University, Ramat Gan, Israel. “Our findings highlight the importance of systematic follow-up for all children who initiated methylphenidate treatment before the age of 8 and persisted in their treatment.”
Antidepressant prescriptions in adolescence may reflect a continuation of the underlying emotional and behavioral dysregulation present in the patients during childhood, Dr. Madjar and colleagues wrote.
Madjar N, Shlosberg D, Leventer-Roberts M, et al. Childhood methylphenidate adherence as a predictor of antidepressants use during adolescence. European Child & Adolescent Psychiatry. 2019 March 4;[Epub ahead of print].