Matthijssen AFM, Dietrich A, Bierens M, et al. - Researchers investigated whether methylphenidate remains beneficial in children and adolescents with ADHD following 2 years of use. They randomized 94 children and adolescents (ages 8–18 years) who had been treated with methylphenidate for > 2 years to a double-blind continuation of treatment for 7 weeks (36 or 54 mg/day of extended-release methylphenidate) or gradual withdrawal over 3 weeks, to 4 weeks of placebo. The discontinuation group displayed significantly more deterioration of the ADHD Rating Scale inattention subscale and the Conners’ Teacher Rating Scale-Revised: Short Form ADHD index and hyperactivity subscale. In the discontinuation group, 40.4% had worsening of Clinical Global Impressions improvement scale vs 15.9% in the continuation group. These findings thus support the efficacy of continued treatment with methylphenidate after long-term use. However, methylphenidate could be withdrawn in some patients without deterioration. According to the researchers, guideline recommendations of periodical assessment of patients to determine whether there is a continued need for methylphenidate treatment are supported by these findings.