Decreased Serum Glucose Levels after??Initiation of Methylphenidate in??a??Patient Status Post-Cerebellar Tumour Resection

Abstract

Pharmacological intervention with methylphenidate to address the neurobehavioural deficits associated with various neurological disorders has increased during the past decade. One potential effect of methylphenidate use is its possible influence on serum glucose. This case report illustrates a significant post-intervention decrease in blood glucose levels subsequent to initiation of methylphenidate to address neurocognitive deficits, status post-acute cerebellar tumour resection, in a 38-year-old female with type 2 diabetes mellitus. A decrease of 26% in serum glucose values was seen from the pretreatment to the post-treatment phase (p = 0.003). Hypotheses concerning drug-drug interactions are offered to explain this unusual outcome. Although anecdotal, this finding has important implications for use of methylphenidate in the treatment of persons with diabetes and should be considered in light of the recent vote of the Drug Safety and Risk Management Advisory Committee of the US FDA urging 'black box' warnings on stimulant medications used to treat attention-deficit/hyperactivity disorder.

Methylphenidate Has Positive Hypocholesterolemic and Hypotriglyceridemic Effects: New Data

“…Satterfield et al 12 found no association between prolonged administration (1–4 years) of methylphenidate to hyperactive boys regarding hematopoietic, endocrine (including glucose levels), hepatic, or cardiovascular functions analyzed in their study. However, Gontkovsky et al 13 reported a decrease of 26% in serum glucose values after methylphenidate initiation in a patient after a cerebellar tumor resection. Vitiello 14 did not find clinically significant changes in cardiovascular function in the majority of cases investigated.…”

“…The cause of lipid metabolism abnormalities is mainly genetic. The secondary causes of dyslipidemia are well‐known and include inappropriate lifestyle, liver disease, renal disease, and hypothyroidism 13 . The different drugs that are known to affect lipid metabolism include hormones (glucocorticoids, estrogens, and androgens), beta‐blockers, diuretics, and others 13 .…”

“…The secondary causes of dyslipidemia are well‐known and include inappropriate lifestyle, liver disease, renal disease, and hypothyroidism 13 . The different drugs that are known to affect lipid metabolism include hormones (glucocorticoids, estrogens, and androgens), beta‐blockers, diuretics, and others 13 . Many recently developed drugs were designed to be started early in childhood to improve various organ somatic, cognitive, and neuropsychiatric functions.…”

Prevalence of enuresis in a community sample of children and adolescents referred for outpatient clinical psychological evaluation: Psychiatric comorbidities and association with intellectual functioning

“…Literature is lacking concerning the potential negative side effects and interactions of other medications prescribed for the management of psychiatric symptoms in children and adolescents, particularly the various psychostimulants utilised in the treatment of ADHD. Only one report in the literature deals with a potential negative interaction of methylphenidate with glipizide (Gontkovsky et al 2007).…”

Methylphenidate and Dyslipidemia

“…Gontkovsky et al (14) reported a decrease o f 2 6 % i n s e r u m g l u c o s e v a l u e s a f t e r methylphenidate initiation in a patient post-cerebellar tumour resection. Being a neurostimulant, the possible linkage of methylphenidate to the cardiovascular system was investigated.…”