Discuss methylphenidate for your child
This first medication option has strong evidence for reducing ADHD symptoms in school age children.
High certaintyADHD evidence
Start with the time you have
1 minute
Type one line in your phone notes: the difficulty your child would want treatment to help with.
5 minutes
Write down one thing you hope it helps and one worry, to take to the prescriber.
15 minutes
List the support your child already gets, their health conditions and medicines, and what you want to ask about monitoring.
A plan
Prepare a medication discussion
- Agree the problems treatment should address.
- Discuss suitability and monitoring with the clinician.
- Bring feedback from your child and school to the planned review.
How sure the science is
High certainty, ADHD evidence
Enough good trials that more research is unlikely to change this number much. Measured in people with ADHD.
- 6 trials
- 1038 people
- children and teens
- clinician rated
- about 12 weeks
- measured on core ADHD symptoms
EBI re-estimation: 6 trials, 1038 children and adolescents, short term; NICE NG87 1.7.7 first-line medicine. See this row on the evidence map
The number, drawn
Why it matters
Methylphenidate changes brain signalling involved in attention and behaviour. EBI rates the evidence high certainty: clinicians scored symptoms in school age children and adolescents 0.762 SMD better than on placebo, a standardised score gap rather than a percentage. That covers about 12 weeks, or the end of the trial, so lasting benefit is not proven. Cochrane's 2025 review used different methods and rated its evidence very low certainty (teacher-rated SMD 0.74, 21 trials), so the high rating holds for the EBI analysis only.
How to do it
- Ask whether methylphenidate, which NICE recommends as the first medicine for children aged 5 and over, fits your child's needs.
- Bring one or two real examples of what your child wants treatment to help with.
- Talk through what it should help, the side effects, and how the clinician will check both.
- Settle how your child, your family and the school will report changes at follow-up.
Only a qualified prescriber can decide whether methylphenidate suits your child. The estimate is for school age children and does not apply to preschoolers.
Putting it into practice
In real life
- A teacher's note on how your child takes part in lessons, plus your child's own goal in their words.
- Ask how appetite and sleep will be checked, not only whether symptoms improve.
Watch out for
- Common mistakeLooking calmer is not the only goal. Talk about how your child joins in and how they feel.
- Common mistakeA trial average cannot predict how your child will respond, so agree follow-up for them in particular.
Trusted guides
How we rated it
- Evidence grade
- A Moderate or high certainty evidence in people with ADHD, or an explicit ADHD guideline recommendation.
- The number
- Children and teens: medium symptom improvement vs placebo over about 12 weeks (SMD 0.762) (BMJ / Gosling et al., 2025)
- Benefit
- 92/100 The benefit score is an editorial prioritization for the general list, weighted by certainty. It is not a prediction of what will happen for you.
- Effort
- Some effort
Sources
- Tier 1 guidelineEBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffbBMJ / Gosling et al., 2025
- Tier 1 guidelineBenefits and harms of ADHD interventions: umbrella review and platform for shared decision makingBMJ, 2025
- Tier 1 guidelineAttention deficit hyperactivity disorder: diagnosis and management (NG87), recommendationsNICE, 2019
- Tier 1 guidelineCommon questions about methylphenidate for childrenNHS, 2025
- Tier 1 guidelineMethylphenidate for children and adolescents with attention deficit hyperactivity disorderCochrane, 2025
General information about ADHD, not a diagnosis or an individual treatment plan. Tailoring changes the order of suggestions; it does not assess you. Medication decisions belong with you and a qualified clinician.