Long-term use and discontinuation of methylphenidate with hyperactive children.

The long-term effects of methylphenidate on the behavior and academic functioning of hyperactive children are described. 36 children having a positive response to methylphenidate entered a three-year follow-up study in which they were closely monitored physically, behaviorally and psychometrically. During this period 13 children spontaneously discontinued medication: there were no statistically significant differences between them and the children who continued medication in terms of age, IQ or ratings at initial interview. The greatest improvement in performance occurred in the early months of treatment, but was only partially maintained during long-term therapy and little further change occurred after medication was discontinued. The findings indicate that sustained improvement is related to factors other than continued medication, and they suggest that drug therapy should be regarded as a short-term intervention until more positive social and school behavior can be established.