Table 3.

Studies that recorded and discussed changes in behavior

Study	Adler et al31	Cherland and Fitzpatrick63	Karabekiroglu et al59	PATS group40–42	Ramtvedt et al64
Study design	Open-label	Retrospective	Open-label	Crossover, parallel	Crossover
Treatment period	6–12 months	21 months	15 days	70 weeks	6 weeks
Follow-up	No	No	No	Yes	No
Patients completed	550	98	90	165	34
Age, years	18–65	4–17	5–15	3.5–5	11.3
Placebo group	No	No	No	Yes	Yes
Methylphenidate-naïve	No	Not known	Yes	Yes	Yes
Limit for symptoms	10%	Not known	Not known	15 most frequent	Not known
Changes in behavior	1.8%	Single cases	No	Yes	Yes
Focus of study	Changes in behavior in relation to long-term safety of methylphenidate	Psychotic side effects of methylphenidate	Short-term side effects of methylphenidate	Safety and tolerability of methylphenidate	Use of methylphenidate in minimizing adverse events

Notes: For Adler et al, changes in behavior were mentioned in the article, but are not shown in the tables.³¹ For Cherland and Fitzpatrick, it was impossible to determine with certainty whether the behavioral changes observed were reversible.⁶³ The Karabekiroglu et al study was specifically designed to study short-term effects.⁵⁹ Subjects in the PATS group studies used methylphenidate off-label because of their age.⁴⁰–⁴² In Ramtvedt et al, methylphenidate treatment was limited to 2 weeks.⁶⁴