From the Guidelines
El metilfenidato es el tratamiento de primera línea para el trastorno por déficit de atención e hiperactividad (TDAH) en niños y adolescentes, debido a su eficacia y perfil de seguridad bien establecido. El metilfenidato es un estimulante del sistema nervioso central que actúa aumentando la actividad de los neurotransmisores dopamina y norepinefrina en el cerebro, lo que ayuda a mejorar la atención, el enfoque y el control del comportamiento 1. Los estudios han demostrado que el metilfenidato es eficaz en reducir los síntomas del TDAH, incluyendo la hiperactividad, la impulsividad y la falta de atención 1.
Algunos de los beneficios del metilfenidato incluyen:
- Eficacia en reducir los síntomas del TDAH
- Disponibilidad en diferentes formulaciones, incluyendo versiones de liberación inmediata y prolongada
- Puede ser administrado una vez al día, lo que puede mejorar la adherencia al tratamiento
- Está disponible en diferentes presentaciones, incluyendo tabletas, líquidos y parches transdérmicos
Sin embargo, es importante tener en cuenta los posibles efectos secundarios del metilfenidato, que pueden incluir:
- Disminución del apetito
- Trastornos del sueño
- Aumento de la presión arterial y la frecuencia cardíaca
- Dolor de cabeza
- Irritabilidad
Es fundamental que los pacientes que toman metilfenidato sean monitoreados regularmente por un profesional de la salud para evaluar la eficacia del tratamiento y ajustar la dosis según sea necesario 1. Además, es importante que los pacientes y sus familiares estén informados sobre los posibles efectos secundarios y los beneficios del tratamiento con metilfenidato.
En resumen, el metilfenidato es un tratamiento eficaz y seguro para el TDAH en niños y adolescentes, siempre y cuando se utilice bajo la supervisión de un profesional de la salud y se monitoree regularmente. Es importante considerar los posibles efectos secundarios y los beneficios del tratamiento al tomar una decisión informada sobre el uso del metilfenidato 1.
From the FDA Drug Label
Misuse and abuse of CNS stimulants, including methylphenidate hydrochloride oral solution, can result in overdose and death [see Overdosage (10)], and this risk is increased with higher doses and or unapproved methods of administration, such as snorting or injection. Methylphenidate hydrochloride oral solution may produce physical dependence. Physical dependence is a state that develops as a result of physiological adaptation in response to repeated drug use, manifested by withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug Methylphenidate hydrochloride oral solution may produce tolerance Tolerance is a physiological state characterized by a reduced response to a drug after repeated administration (i.e., a higher dose of a drug is required to produce the same effect that was once obtained at a lower dose). The metilfenidato (methylphenidate) can cause:
- Dependence: The drug may produce physical dependence.
- Tolerance: The drug may produce tolerance.
- Overdose risk: The risk of overdose and death is increased with higher doses and unapproved methods of administration. 2
From the Research
General Information about Metilfenidato
- Metilfenidato, also known as methylphenidate, is a central nervous system stimulant commonly used to treat attention-deficit/hyperactivity disorder (ADHD) in adults and children 3, 4.
- It works primarily as a dopamine and noradrenaline reuptake inhibitor, and also protects the dopaminergic system against the ongoing 'wearing off' 3.
Efficacy of Metilfenidato
- Methylphenidate has been shown to be moderately effective in reducing core ADHD symptoms and accompanying emotion regulation deficits in adults 3.
- In children and adolescents, methylphenidate and atomoxetine have comparable efficacy and acceptability in treating ADHD, although OROS methylphenidate may be more effective than atomoxetine 5.
- Both methylphenidate and atomoxetine have been found to improve emotional and behavioral problems in youths with ADHD, with methylphenidate showing greater improvement in aggressive behavior, somatic complaints, and conduct problems 6.
Comparison with Other Treatments
- A head-to-head randomized clinical trial found that both methylphenidate and atomoxetine improved executive functions in adults with ADHD, with atomoxetine showing greater efficacy in improving spatial planning 7.
- A meta-analysis found no significant difference in efficacy between methylphenidate and atomoxetine in treating ADHD in children and adolescents, although OROS methylphenidate was found to be more effective than atomoxetine 5.
Safety and Adverse Events
- Common adverse events related to long-term treatment with methylphenidate include decreased appetite, dry mouth, heart palpitations, gastrointestinal infections, and agitation/feeling restless 3.
- Methylphenidate has been found to have a good safety profile, with dose optimization potentially enhancing the safety and efficacy of treatment 4.