Long-Term Safety and Efficacy of Stimulant Medications in Pediatric ADHD: Population-Based Cohort Study with Systematic Review

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5-7% of children and 2.5% of adults worldwide [1]. Stimulant medications including methylphenidate (MPH) and amphetamines (AMP) remain first-line despite cardiovascular and psychiatric safety concerns [4]. Objective: Comprehensive assessment of long-term cardiovascular safety, psychiatric risk profile, and therapeutic efficacy utilizing population-based cohort data [5]. Methods: Systematic review 2010-2025 across major medical databases evaluating cardiovascular events, hemodynamic changes, psychosis incidence, and academic outcomes [14]. Results: 0.92 cardiac events and 3.08 cardiac symptoms per 1,000,000 treatment days [5]. Current stimulant use aOR 0.69 (95%CI 0.42-1.12) vs non-users[5]. MPH demonstrated no short/long-term psychosis risk elevation [8]. MTA 8-year: +12% GPA, 56% symptom remission [10]. Conclusion: Protocolized stimulant therapy exhibits favorable safety-efficacy balance [11].