Efficacité et tolérabilité du méthylphénidate chez les enfants et adolescents présentant un TDAH: Revue systématique
DOI :
https://doi.org/10.62438/tunismed.v104i05.6710Mots-clés :
Methylphenidate, enfants et adolescents, tolérance, efficacité, trouble déficit de l’attention avec hyperactivitéRésumé
Introduction : Le méthylphénidate demeure le psychostimulant de première intention le plus prescrit pour la prise en charge du trouble déficit de l’attention avec ou sans hyperactivité (TDAH). Cependant, des préoccupations persistent quant à sa sécurité d’emploi et à son impact potentiel sur le développement neurologique au cours des périodes critiques de croissance.
Objectifs : L’objectif de cette étude était de réaliser une revue systématique de la littérature afin d’évaluer l’efficacité et la tolérance du méthylphénidate dans le traitement du TDAH chez les enfants et les adolescents, et d’examiner l’applicabilité des recommandations internationales en Tunisie.
Méthodologie : Une revue systématique a été conduite selon la méthodologie PRISMA. La recherche bibliographique a été effectuée sur PubMed, google scholar et science direct en utilisant les mots-clés : « methylphenidate », « children and adolescents », « efficacy », « tolerability » et « ADHD
», pour la période allant de 2015 à 2025.
Résultats : Notre étude a inclus 28 articles, comprenant des essais cliniques, des essais contrôlés randomisés et des études de cas. Les résultats montrent de manière cohérente que le méthylphénidate améliore les symptômes centraux du TDAH ; attention, hyperactivité et impulsivité, tout en favorisant le fonctionnement exécutif, la cognition sociale et la régulation émotionnelle. Globalement, le méthylphénidate est bien toléré, les effets indésirables les plus fréquents étant la diminution de l’appétit, l’insomnie, l’irritabilité et de légères modifications cardiovasculaires. Les effets sur la croissance sont généralement modérés et réversibles, et les événements indésirables graves demeurent rares.
Conclusion : Nos résultats soutiennent l’efficacité à court terme et la tolérance satisfaisante du méthylphénidate chez les enfants et les adolescents atteints de TDAH, tout en mettant en évidence des incertitudes concernant les effets à long terme.
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