How appropriate is the increased use of methylphenidate? A practice audit and placebo-controlled discontinuation trial

At the beginning of this century, there has been a steep increase in the number of prescriptions of methylphenidate to children and adolescents to reduce concentration problems and hyperactive behaviour. In parallel, public debate arose about the possible overdiagnosis of attention-deficit/hyperactivity disorder (ADHD) and overtreating children with methylphenidate. In several studies I investigated the extent to which methylphenidate is used appropriately.
I conclude that, on average, methylphenidate is still an effective treatment after two years of use. However, a significant proportion of children and adolescents, can stop taking the medication without deterioration. This shows that there is a group of children and adolescents who continue to take medication unnecessarily use and are therefore unnecessarily exposed to possible negative effects in the long-term, such as reduced height. In practice, therefore more attention should be paid to when and how to stop medication.
I also conclude that in adherence to guidelines for the diagnosis and treatment of ADHD, there is much room for improvement, both in adherence to recommendations for the diagnosis of ADHD and for the indication of methylphenidate. Better adherence to guidelines contributes to children and adolescents receiving the right care more often and less likely to receive unnecessary or potentially ineffective treatment.