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

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.