Childhood methylphenidate adherence as a predictor of antidepressants use during adolescence

  • Nir MadjarEmail author
  • Dan Shlosberg
  • Maya Leventer-Roberts
  • Amichay Akriv
  • Adi Ghilai
  • Moshe Hoshen
  • Amir Krivoy
  • Gil Zalsman
  • Gal Shoval
Original Contribution


Methylphenidate (MPH) is a common and effective treatment for attention deficit hyperactivity disorder (ADHD), but little is known about the relationship between early childhood intake of MPH and onset of antidepressant treatment during adolescence. The study aimed to examine whether adherence to MPH during early childhood predicts the initiation of antidepressants during adolescence. This is a 12-year historical prospective nationwide cohort study of children enrolled in an integrated care system who were first prescribed MPH between the ages of 6 and 8 years (N = 6830). We tested for an association between their adherence to MPH during early childhood (as indicated by medication possession ratio from MPH onset through the age of twelve) and the likelihood of being prescribed any antidepressant during adolescence (age 13–18). As all country citizens are covered by mandatory health insurance, and full services are provided by one of the four integrated care systems, data regarding patients’ diagnoses, prescriptions, and medical purchases are well documented. Logistic regression analysis indicated that those with higher adherence to MPH had a 50% higher risk (95% CI 1.16–1.93) of receiving antidepressants during adolescence when controlling for other comorbid psychiatric conditions and parental use of antidepressants. In this large-scale longitudinal study, MPH adherence during early childhood emerged as a predictor for antidepressant treatment during adolescence, which may reflect increased emotional and behavioral dysregulation in this group. The highly adherent patients are at higher risk and should be clinically monitored more closely, particularly into adolescence.


Attention deficit hyperactivity disorder Methylphenidate Antidepressants Adherence Depression Anxiety Longitudinal analysis 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Social Sciences, School of EducationBar-Ilan UniversityRamat GanIsrael
  2. 2.Clalit Research InstituteClalit Health ServicesTel AvivIsrael
  3. 3.Department of Pediatrics and Preventive MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  4. 4.Geha Mental Health CenterPetah TikvaIsrael
  5. 5.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  6. 6.Division of Molecular Imaging and Neuropathology, Department of PsychiatryColumbia UniversityNew YorkUSA

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