Influencing factors for methylphenidate treatment discontinuation in children with attention-deficit/hyperactivity disorder

XU Cuijuan; XU Qi; WANG Jianhong; ZHOU Bo; ZHANG Lili; WANG Lin

doi:10.11852/zgetbjzz2025-1089

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (6) : 636-641. DOI: 10.11852/zgetbjzz2025-1089

Special Column on Attention-Dificit/Hyperactivity Disorder

Influencing factors for methylphenidate treatment discontinuation in children with attention-deficit/hyperactivity disorder

XU Cuijuan^1,2, XU Qi¹, WANG Jianhong¹, ZHOU Bo¹, ZHANG Lili¹, WANG Lin^1,2

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Abstract

Objective To analyze factors associated with discontinuation of methylphenidate (MPH) among children with attention-deficit/hyperactivity disorder (ADHD) receiving methylphenidate hydrochloride prolonged-release tablets (MPH), so as to provide a scientific reference for improving clinical adherence. Methods A retrospective study was conducted in 174 children with ADHD who initiated oral MPH treatment for the first time and completed follow-up at the ADHD clinic of the Child Healthcare Center, Capital Center for Children′s Health, Capital Medical University, from August 2022 to March 2024.According to whether treatment was maintained for at least 6 months after initiation, participants were divided into a medication retention group and a medication discontinuation group.The Swanson, Nolan, and Pelham Rating Scale-Parent Version (SNAP-Ⅳ-P) and Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) were adopted to assess attention. Independent-samples t-tests were performed to compare total SNAP-Ⅳ scores, comprehensive response control quotient, and comprehensive attention quotient between the two groups.Multivariate logistic regression analysis and Chi-square test were performed to explore factors associated with MPH treatment discontinuation in orally treated children. Results A total of 174 children with ADHD who received MPH treatment were included in the study.Among them, 71 cases were in the medication discontinuation group, consisting of 48 males and 23 females, with an average age of (9.96±1.56) years.The remaining 103 cases were in the medication retention group, comprising 85 males and 18 females, with an average age of (9.87±1.65) years.No significant differences were found between the two groups in total score of SNAP-Ⅳ-P, comprehensive response control quotient, or comprehensive attention quotient of the IVA-CPT (P>0.05).Multivariate logistic regression showed that girls (OR=2.777, 95%CI: 1.276 - 6.046), residence in suburban areas (OR=2.588, 95%CI: 1.313 - 5.099), and adverse drug reactions (OR=4.671, 95%CI: 2.293 - 9.297) were associated with an increased risk of treatment discontinuation (P＜0.05).A primary caregiver education level of bachelor′s degree (OR=0.118) or postgraduate and above (OR=0.095) was associated with a reduced risk of discontinuation (P＜0.05). Conclusions The rate of MPH discontinuation among children with ADHD is notably high and is significantly associated with factors such as gender, residence place, the educational level of the primary caregiver, and adverse drug reactions.To enhance treatment adherence, it is essential to strengthen follow-up management, provide comprehensive medication counseling, and improve the clinical handling of adverse effects.

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attention-deficit/hyperactivity disorder / methylphenidate / medication discontinuation / compliance

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XU Cuijuan, XU Qi, WANG Jianhong, ZHOU Bo, ZHANG Lili, WANG Lin. Influencing factors for methylphenidate treatment discontinuation in children with attention-deficit/hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2026, 34(6): 636-641 https://doi.org/10.11852/zgetbjzz2025-1089

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