AHDS and Medikinet: long-term effects and safety

ADHD and Medikinet: long-term effects and safety

ADHD Medikinet: Find out what long-term effects are possible, what studies show about safety and how risks can be reduced through medical supervision.

If you or your child has been diagnosed with ADHD, the name Medikinet is probably not new. It is one of the best-known and internationally most frequently prescribed medications for the treatment of ADHD in children, adolescents and, increasingly, adults. But what about its long-term safety? What side effects can occur – and what do current studies say about this?

Concerns about medication are understandable – and education is essential.

What is Medikinet anyway?

Medikinet contains the active ingredient methylphenidate, a so-called psychostimulant that belongs to the amphetamine group. It acts directly on the central nervous system and increases the concentration of dopamine in the brain – a neurotransmitter that is typically released too quickly from the synaptic cleft in ADHD sufferers. This leads to familiar symptoms such as inattention, impulsivity and hyperactivity.

Methylphenidate therefore not only has a “calming” effect, but also helps to keep dopamine levels stable – which in turn can lead to greater clarity, better self-regulation and improved ability to concentrate.

Part of a comprehensive therapy

Important: Medikinet is not a miracle cure. It is used as part of a so-called multimodal therapy. This means that successful treatment also includes psychotherapeutic support, behavioral therapy or psychoeducation. Medication alone is no substitute for long-term coping strategies – but it can make everyday life much easier, especially in particularly stressful phases.

Efficacy – proven many times over

The effectiveness of methylphenidate is very well documented. Numerous clinical studies and meta-analyses show: In correctly diagnosed ADHD, the medication helps in the vast majority of cases.Concentration and impulse control improve measurably, academic and professional performance stabilizes, and social relationships can relax.

Nevertheless, many people are concerned: what happens if you take the medication for months or even years? Isn’t that dangerous?

The downside: Side effects – and uncertainty about long-term consequences

The Medikinet package leaflet alone contains a long list of possible side effects – which is unsettling. These are particularly common:

• Loss of appetite and weight loss
• Sleep disorders (e.g. problems falling asleep)
• Headaches, nausea or dizziness
• Dry mouth, muscle cramps or skin rashes
• visual disturbances

There is also talk of possible growth retardation, especially in children. Rarer but more serious are cardiovascular problems such as an increase in blood pressure, palpitations or even cardiac arrhythmia. In extremely rare cases, even sudden deaths have been described – albeit mostly with pre-existing heart problems. For this reason, ECG and blood tests are mandatory before starting treatment at GAM Medical.

Methylphenidate in the long term – a complex question

As methylphenidate is often taken for years – sometimes continuously – the question of long-term safety arises. Particularly in childhood and adolescence, at a time when the brain is still developing, concerns are understandable.

Some experts warn against using such medication too lightly. In particular, if they are prescribed by non-specialist doctors, this can lead to misjudgements and inadequate monitoring. GAM Medical therefore also advises regular follow-up discussions and a drug-free observation period after around one year – together with the treating doctors.

What does research say about long-term use?

Although a great deal of data is available on short-term efficacy, large long-term studies on safety and tolerability have only been published in recent years.Four studies stand out in particular:

ADDUCE study

One particularly extensive and current project is the ADDUCE study, which was published in 2023 as an EU-funded study. The aim was to specifically test the long-term safety of methylphenidate in children and adolescents. A total of 1,410 young people from five European countries were included in the study, who were followed over a period of two years. The focus was on the effects on physical growth, the cardiovascular system, possible psychiatric side effects and the risk of abuse and danger to others. The results are reassuring: there was no significant increase in the risk of suicide, and the observed increase in heart rate and blood pressure was statistically low and medically harmless. There was no increase in neurological or psychiatric disorders. On the contrary: the study even suggests that stable ADHD treatment with methylphenidate can reduce the risk of becoming a victim of violence or abuse. The researchers conclude that methylphenidate is overall safe and well tolerated when used correctly – but emphasize the need for regular medical follow-up.

MTA study

The MTA study (Multimodal Treatment Study of ADHD), one of the largest long-term studies from the USA, had already provided important data. It began back in the 1990s and followed children with ADHD over many years. Here, too, the high effectiveness of methylphenidate in acute use was confirmed. One interesting finding concerned body growth: this appeared to be somewhat slower with long-term use – but without serious health consequences. An increased risk of addiction or dependence was not found as part of a specialist-led therapy.

Scandinavian cohort study

In addition, Scandinavian cohort studies from Norway and Sweden (2015-2023) provide important findings from the reality of care. They confirm that there is no increased risk of heart attacks, strokes or substance-related disorders in children, adolescents and adults who take methylphenidate over long periods of time.Interestingly, the data even show that untreated ADHD sufferers are significantly more likely to develop risky or addictive consumption behavior – which underlines the importance of controlled drug therapy.

Neuroscientific research

Neuroscientific research has also focused intensively on the question of whether methylphenidate causes long-term structural changes in the brain. Studies conducted between 2007 and 2020 using imaging techniques such as MRI identified evidence of changes in certain regions of the brain in children with early and long-term use. However, whether these changes actually have a functional or emotional impact has not yet been proven. The clinical relevance therefore remains unclear, and there is currently no evidence of negative long-term cognitive or psychological consequences.

Conclusion of the study situation

Overall, a differentiated but largely positive picture emerges from these four studies: when taken under medical supervision and embedded in a multimodal treatment concept, methylphenidate is safe and well tolerated – even over longer periods of time. However, individual support, regular follow-up and honest communication about possible side effects remain crucial.

What about addiction potential and suicide risk?

As mentioned, Medikinet contains an amphetamine-like active ingredient. Therefore, there is always discussion about a possible addictive potential. However, the current study situation is clear:

• In persons with ADHD, methylphenidate has a focusing, not intoxicating

effect

• The “kick” is absent – therefore the risk of addiction is extremely low when taken under medical supervision
• The situation is different for people without ADHD: Here, abusive use (e.g. by students to improve performance) can have a euphoric effect – with corresponding risks

In individual cases, psychotic symptoms or depression have been observed in connection with methylphenidate. An older study with 100 children over 5 years showed a psychosis rate of around 6%. However, this data is controversial and has been relativized by more recent studies.

Suicidal thoughts are also repeatedly discussed.Important to know: Medications such as Medikinet can exacerbate existing psychological stress, especially in adolescents. This makes close medical and psychological support, as we offer at GAM Medical, all the more important.

What does this mean for you specifically

?
If you or your child is taking Medikinet, it is perfectly understandable that you are concerned about possible side effects. The good news is that the long-term data available today show a predominantly positive risk-benefit ratio – provided the treatment is medically supervised and embedded in an overall therapeutic concept.

Above all, it is important:

• Regular check-up appointments
• Pause phases to reassess the need for medication
• Supplementary measures such as psychoeducation, coaching or behavioral therapy
• Honest communication about side effects and concerns

Conclusion: Used responsibly – a valuable aid

Medikinet is not a panacea – but for many ADHD sufferers it is a crucial building block on the way to a functioning everyday life. Long-term research shows: Most risks can be well controlled through education, medical supervision and accompanying therapies.

If you have any questions or are unsure, talk to us. At GAM Medical, we take your concerns seriously – and provide you with professional, empathetic and scientifically sound support.