Methylphenidate-Induced Raynaud’s Phenomenon In Two Cases With Attention-Deficit/Hyperactivity Disorder

Abstract

Attention -deficit / hyperactivity disorder is a common neurodevelopmental disorder in childhood, for which there are several different treatment options. Among the suggested medications, methylphenidate (a central nervous system stimulant) is the first option in the treatment of ADHD. Psychostimulants are associated with various vascular problems including peripheral vasculopathy. This report describes two patients with ADHD who developed Raynaud's phenomenon during the modified-release methylphenidate treatment.

Modified-release methylphenidate-induced Raynaud’s phenomenon in an adolescent with attention deficit hyperactivity disorder

“…However, no similarity or difference was reported in any of the previous reports. To the best of our knowledge, this is the second report to the effect that the vascular side-effects of MPH may vary depending on the type of MPH 9 .…”

“…In the cases reported by Syed et al, Yu et al, Meridor et al, and Ferahkaya et al methylphenidate was stopped and not resumed subsequently. RF was therefore observed again after resumption of the medication 8,9,10,11 . All these findings suggest a relationship between RP development and stimulants.…”

“…Raynaud's phenomenon (RP) is a peripheral vasculopathy potentially associated with connective tissue diseases characterized by recurring reversible vasospasm attacks triggered by cold and emotional stress 7 . Several cases have been published involving RP observed with MPH 8,9 . The present case discusses a 14-year-old girl with ADHD who experienced RP with the addition of 10 mg modified-release MPH during 27 mg osmotic release (OROS)-MPH therapy, but not during 36 mg OROS-MPH therapy.…”

“…There are a limited number of cases in the literature concerning the relationship between RP and psychostimulants such as modified-release methylphenidate, OROS-MPH and dextroamphetamine in children and adolescents 8,9,10,11 . In cases, A significant association was observed between presence of RP and previous or current stimulant use for the treatment of ADHD.…”