MASK

Methylphenidate, better known by the brand names Ritalin and Concerta, is the first-line choice when medication-based treatment is selected for children with ADHD. Its efficacy in the short term (three months to two years) has been thoroughly investigated. However, less is known about its long-term efficacy. This is despite the fact that 60% of the children are still using the medication after two years.

The Methylphenidate Tapering Study in Children (MASK) involved 94 children and adolescents who had already been taking the medication for over two years. Half of the children continued to take the medication throughout the study duration of seven weeks. The other half gradually tapered the medication and took a placebo (fake pill) for a few weeks. Nobody knew to which group a child had been allocated. We compared the two groups with each other in terms of ADHD symptoms. We also observed individual children to see whether they deteriorated or not after they stopped taking the medication.

• The initial results show that, as a whole, the group of children who tapered displayed more ADHD characteristics - both at home and in school - after seven weeks than the group of children who continued to take the medication. This was particularly evident among the younger participants in the study.
• However, if the focus is on each individual child, rather than the group as a whole, it appears that 60% of the children who tapered did not deteriorate or only deteriorated slightly.
• The group of children who phased out also showed more behavioral problems, but we found no differences between the groups for quality of life or parental stress.

This demonstrates the importance of a trial stop. As future steps, we will also explore whether phasing out the medication has an effect on cognitive functions or biomarkers.

This research study involves collaboration between Accare and Karakter Child and Adolescent Psychiatry.