Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Diidn't your incompetent? doctor start using methylphenidate over a decade ago?

methylphenidate (7 posts to September 2015)

Methylphenidate, sold under the brand name Ritalin and Concerta, among others, is a central nervous system (CNS) stimulant used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.

 Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abinivesh Sathyanarayanan 1 , Sunil Vummiti 2 , Afreen Pudukayil Pudiyamaliyakkal 3

 1. Cardiology, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR 

2. Diabetes and Endocrinology, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR 

3. Medicine and Surgery, Aston University, Birmingham, GBR Corresponding author: Abinivesh Sathyanarayanan, abi2003221@gmail.com 

 Abstract 

 Cerebrovascular disease carries significant morbidity and mortality worldwide. Medical practice has come a long way in optimizing risk factors, managing acute stroke, and preventing recurrence. There are a multitude of complications, ranging from spasticity and neuropathic pain to behavioural changes. The post stroke period typically consists of medical management of symptoms and physical rehabilitation to recover motor function. Many patients also require occupational therapy and holistic support. Therefore, patients who have suffered a stroke require a multi-disciplinary approach to management; this is often lengthy and resource-intensive.(What a fucking joke of a useless line!) There has been much research into interventions aimed at reducing patient morbidity and improving their quality of life. A systematic review of randomized controlled trials and a meta-analysis of results were carried out to assess the effects of methylphenidate, a dopamine and noradrenaline reuptake inhibitor, on post-stroke rehabilitation, keeping in consideration functional outcome measures and effect on mood. Limitations encountered include the quality of studies, small sample sizes, differences in treatment protocol, and varied outcome measures. There is some evidence to suggest methylphenidate may have a positive effect on mood, but there were no significant results to support its use in functional recovery. There is a need for larger trials with more sensitive and standardized outcome measures. Categories: Neurology, Pharmacology, Physical Medicine & Rehabilitation Keywords: methylphenidate (mph), neuro rehabilitation, post-stroke mood disorder, post-stroke recovery, stroke medicine Introduction And Background Stroke remains a leading cause of death and disability, affecting 100,000 people per year in the United Kingdom. This places a significant burden, approximately £3 billion annually, on the NHS, both in its acute management and in dealing with its sequelae [1]. Despite rapid advancements in its prevention and treatment with novel therapies such as Sanbexin® (edaravone and dexborneol), glibenclamide, etc. being studied, research into post-stroke rehabilitation lags behind [2,3]. The ongoing search for pharmacological agents to enhance neuroplasticity and motor recovery post-stroke is a key research area. Various medications and device-based therapies are under investigation. However, currently there are no guidelines on the use of these options to supplement conventional therapy. This systematic review and meta-analysis aim to investigate the use of methylphenidate in rehabilitation after stroke, specifically with motor function. Secondarily, effects on mood and adverse effects of treatment will also be considered. A quarter of strokes occur among the working population; depending on its severity, it may ruin their careers and affect their support network. Managing disability, both physical and psychological, could play a key role in dealing with this [1]. Theory Methylphenidate functions as a CNS stimulant by blocking reuptake of catecholamine transporters, increasing synaptic concentration of noradrenaline and dopamine, and prolonging their effects [4]. One rationale for its use in post-stroke recovery is to counteract post-stroke diaschisis, which includes functional suppression of the catecholaminergic system [5]. Clinical studies suggest that methylphenidate enhances activity in underactive neural networks after stroke, particularly in prefrontal and sensorimotor regions [6]. Subsequent cognitive benefit may be seen across domains such as inattention, working memory, and motivation, which are crucial for effective participation in post-stroke rehabilitation [7]. On a cellular level, pre-clinical studies suggest methylphenidate promotes neuroplasticity by increasing neurite outgrowth, dendritic complexity, and synaptic plasticity. These processes provide a pathway for the structural remodelling that will precede functional recovery, though the application of these findings to humans requires further investigation [8,9]. How to cite this article Sathyanarayanan A, Vummiti S, Pudukayil Pudiyamaliyakkal A (November 17, 2025) Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus 17(11): e97053. DOI 10.7759/cureus.97053