A Case of Acute Cardiomyopathy and Pericarditis Associated with Methylphenidate

Dadfarmay, Sina; Dixon, Jennifer

doi:10.1007/s12012-009-9033-7

Cited by 16 publications

(7 citation statements)

References 9 publications

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“…The stimulant sympathomimetics can increase blood pressure by a few millimeters of mercury, but more concerning are reports of sudden death, acute coronary syndrome, MI, stroke, and cardiomyopathy associated with their use. [187][188][189][190][191][192][193][194][195][196] Despite these case reports and small series documenting cardiac toxicity associated with stimulants, large epidemiological studies performed in children and adults treated with stimulants found no increase in the risk of serious cardiovascular events (stroke, MI, and sudden death). 197,198 Considering the case reports and well-recognized risk of sympathetic stimulation in patients with serious cardiac disease, sympathomimetic stimulants are not generally used in patients with HF.…”

Section: Neurological and Psychiatric Medicationsmentioning

confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

359

185

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Heart failure is a common, costly, and debilitating syndrome that is associated with a highly complex drug regimen, a large number of comorbidities, and a large and often disparate number of healthcare providers. All of these factors conspire to increase the risk of heart failure exacerbation by direct myocardial toxicity, drug-drug interactions, or both. This scientific statement is designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients.

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Section: Neurological and Psychiatric Medicationsmentioning

confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

359

185

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“…92,93 For the subpopulation with methylphenidate cardiotoxicity, energy drink use may increase cardiac events. 95,96 As with the ADHD stimulants, the combined effects of energy drinks and antidepressants are unknown. 94 …”

Section: Effects Of Energy Drinks On Children and Adolescents With Adhdmentioning

confidence: 99%

Health Effects of Energy Drinks on Children, Adolescents, and Young Adults

et al. 2011

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"poison control center" to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. RESULTS:According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. CONCLUSIONS:Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research.

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“…More recently, Karaman et al ( 2010) similarly reported pulmonary hypertension occurring in a patient aged 15 years, with clinical signs appearing only four days after initiation of methylphenidate therapy. Classically, methylphenidate is classed among the drugs likely to induce cardiomyopathies (Figueredo 2011; Henderson and Fischer 1995), with numerous reports published in the literature (Dadfarmay and Dixon 2009; Fischer and Baner 1977; Nymark et al 2008; Tollofsrud and Hoel 2006). …”

Section: Discussionmentioning

confidence: 99%

Methylphenidate off-label use and safety

et al. 2014

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IntroductionMethylphenidate is a piperidine derivative structurally and pharmacologically similar to amphetamine. Methylphenidate is indicated for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 6 years of age and over when remedial measures alone prove insufficient. In adults, its indication, except in narcolepsy, is not defined. Methylphenidate received regulatory approval almost sixty years ago with a first registration in Switzerland in October 1954.ObjectiveTo evaluate the off-label use of methylphenidate and its characteristics from a database of spontaneous reports.MethodsThis study analysed data from the French Pharmacovigilance Database of adverse drug reactions spontaneously reported by health professionals from 1985 to December 2011. Off-label use was evaluated according to age.ResultsIn the French Pharmacovigilance database, 181 cases of adverse drug reactions were reported with methylphenidate. Neuropsychiatric effects were the most frequent adverse event reported (41%) followed by cardiovascular and cutaneous side effects (14%). 143 reports concerned children (113 boys, 30 girls, mean age 10.6 ± 3.3 years) of which 46 (30%) were off-label uses. There were 38 adults (20 men, 18 women), of which 32 (88%) off-label use. In adults, methylphenidate was prescribed for depression, and this practice was associated with serious adverse events of drug dependence, overdose and suicide attempt. Overall, off-label use was detected in 43% (78/181) of all cases reported.ConclusionMore than 40% of the patients with drug reactions received methylphenidate for off-label indications. Additional long-term exposures and independent clinical studies are necessary to establish the long-term profile safety of methylphenidate.

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A Case of Acute Cardiomyopathy and Pericarditis Associated with Methylphenidate

Cited by 16 publications

References 9 publications

Drugs That May Cause or Exacerbate Heart Failure

Drugs That May Cause or Exacerbate Heart Failure

Health Effects of Energy Drinks on Children, Adolescents, and Young Adults

Methylphenidate off-label use and safety

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