Efficacy and tolerability of Methylphenidate in children and adolescents with ADHD: A Systematic Review

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Published May 24, 2026
https://doi.org/10.62438/tunismed.v104i05.6710
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Vol. 104 No. 05 (2026): Tunis Med May 2026

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Nour El Houda Ayadi
Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia
Randaline Ayoub
Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia
Hela Ben Abid
Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia
Maha Ajmi
Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia
Asma Guedria
Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia

Abstract

Introduction : Methylphenidate is the most commonly prescribed first-line stimulant for managing Attention-Deficit/Hyperactivity Disorder (ADHD, yet concerns remain regarding its safety and potential impact on neurodevelopment during critical growth periods.
Aim : To systematically review the literature in order to evaluate the efficacy and tolerability of methylphenidate in the treatment of children and adolescents with Attention-Deficit/Hyperactivity Disorder, and to assess the applicability of international guidelines in Tunisia.
Methodology : A systematic literature review was conducted following the PRISMA methodology. The search was conducted in PubMed, google scholar and science direct using the following terms: « methylphenidate », « children and adolescents », « efficacy », « tolerability » and « ADHD ».
The search covered the period from 2015 to 2025.
Results : Our review included 28 articles, comprising clinical trials, randomized controlled trials, and case reports. Findings consistently demonstrate that methylphenidate improves core ADHD symptoms, including attention, hyperactivity, and impulsivity, while also enhancing executive functions,
social cognition, and emotional regulation. This treatment is generally well-tolerated, with commonly reported adverse events including decreased appetite, insomnia, irritability, and mild cardiovascular changes. Growth effects are typically modest and reversible, and serious adverse events
are rare.
Conclusion : Our findings support the short-term efficacy and acceptable safety of methylphenidate in children and adolescents with ADHD, while highlighting uncertainties regarding long-term outcomes.

Keywords:

methylphenidate, children and adolescents, efficacy, tolerability, ADHD

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Author Biographies

Randaline Ayoub, Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia

Child and adolescent psychiatrist, Assistant professor in child and adolescent psychiatry department, Monastir

Hela Ben Abid, Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia

Child and adolescent psychiatrist, Assistant professor in the child and adolescent psychiatry department, Monastir

Maha Ajmi, Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia

Child and adolescent psychiatrist, Assistant professor in the child and adolescent psychiatry department, Monastir

Asma Guedria, Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir,5000, Monastir, Tunisia

child and adolescent psychiatrist, professor and head of the department of the child and adolescent psychiatry, Fattouma Bourguiba Hospital, Monastir

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