Methylphenidate is the active substance, for example in Ritalin and Concerta, two medicines that are prescribed to thousands of Swedish children and adolescents for the treatment of ADHD.
But if and how, how this drug affects the brain in the long run, no one knows.
– Previous studies have attempted to statistically control the effects of this medicine. This is the first study in which we study untreated patients, which – of course – is absolutely crucial to understanding how the drug affects the developing brain, says one of the authors of this study, Lizbeth Reneman of the University of Amsterdam, Radiology magazine. the study.
To find out more, Reneman and her colleagues hired 50 boys and 49 young adults who were diagnosed with ADHD but had not yet started taking methylphenidate.
Patients were then given either methylphenidate or ineffective placebo for 16 weeks while their brains were examined with a magnetic chamber at the beginning and end of the study period.
Using the DTI technique, the white matter of the brain, that is, the part of the brain that is located in the cerebral cortex that controls communication between nerve cells of the cerebral cortex, was examined.
After four months, there were clear changes in white matter with respect to these parameters in treated boys but not in adult adults.
– The results show that adhd drugs can have different effects on the structure of the developing brain. However, in adult men with ADHD, as well as in men and boys who received placebo, these changes do not occur, suggesting that the effect of methylphenidate on the white matter of the brain depends on the age of the patients, Reneman says.
If and if so, what effect these changes have on patients in the long run, the researchers still do not know, but conclude that the regulation accepting this type of medication should be stricter.
"The use of ADHD medicines in children should be carefully considered until we understand more about the long-term effects," says Reneman.
Karl Michael Kelkner of the Swedish Medicines Agency says it is too early to say whether the changes the study sees are a problem.
– Just because you see a change that you cannot understand whether it is good or bad.
– It may be the expected effect of the treatment you have seen, he continues.
He also believes it is already restrictive to administer adhd medicines.
– The recommendations are that you should first try non-pharmacological treatment in a structured environment in order to move and have learning disabilities, says Karl Michael Kälkner.
But the number of children and adolescents taking ADHD medications has increased dramatically in recent years. In 2006, almost 10,000 children aged 0-19 received treatment with central stimulants, in 2018 the figure is just over 50,000.
With regard to the number of patients per 1,000 residents in the same age group, their numbers increased from 4.44 patients in 2006 to 21.57 patients in 2018, according to data from the National Health and Welfare Council.
"Although the increase may seem dramatic, today the levels are quite reasonable," said Peter Salmi of the National Health and Welfare Council.
– There is more general awareness of adhd and it goes fast. It was this development that led to the rapid increase. Not that adhd has increased in society, it is considered permanent. It's a dark figure that is now emerging, he says.
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