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Aim: This study evaluated the efficacy and safety of tipepidine as an add‐on to methylphenidate in the drug treatment of attention‐deficit/hyperactivity disorder (ADHD). Methods: This study was an 8‐week, randomized, parallel group, double‐blind, placebo‐controlled trial recruiting 53 ADHD‐diagnosed children. Patients were randomly divided to receive methylphenidate + tipepidine or methylphenidate + placebo for 8 weeks. Participants were assessed using the parent version of ADHD Rating Scale‐IV and the Clinical Global Impression scale at baseline, at week 4, and at the end of the trial. Moreover, the safety and tolerability of the treatment strategies were compared. Results: On general linear model repeated measures analysis a significant effect was seen for time × treatment interaction on the total and hyperactivity–impulsivity subscales of the Parent ADHD Rating Scale‐IV during the trial period (Greenhouse–Geisser corrected: F = 3.45, d.f. = 1.52, P = 0.049, and F = 5.17, d.f. = 1.52, P = 0.014, respectively). The effect for time × treatment interaction, however, was not significant on Clinical Global Impression‐Severity scale (Greenhouse–Geisser corrected: F = 1.79, d.f. = 1.43, P = 0.182). The frequencies of adverse events were similar between the two groups. Conclusion: Eight weeks of treatment with tipepidine, as a supplementary medication, resulted in satisfactory efficacy and safety of the adjuvant therapy in management of patients with ADHD. Rigorous investigations, however, involving larger sample sizes, more extended treatment periods, and dose responses should be considered. [ABSTRACT FROM AUTHOR]