Methylphenidate is prescribed commonly for children with attention deficit hyperactivity disorder. An estimated 2.8% of US youths aged 5 to 18 years use it for the management of this disorder. Despite the widespread use of methylphenidate, the demographics and outcome of intentional and unintentional exposures to methylphenidate have not been described.
To profile human exposures to methylphenidate, a retrospective review of all reports to a certified regional poison information center during 1998 was conducted. Data analysis included patient demographics, reason for the exposure, dose ingested, clinical effects, and patient outcome.
There were 113 methylphenidate human exposures. The following table summarizes the values for selected parameters that were investigated: [table in text]
The majority of exposures in children < or = 12 years of age involved unintentional ingestion of a sibling's medication, self-administration of an excessive therapeutic dose, or the administration of an inadvertent dose given by a caregiver. Methylphenidate abuse was common among adolescents and adults. Regardless of the reason for the exposure, the amount ingested, or treatment, all exposures had a favorable outcome. Pediatric doses of less than 1 mg/kg were not associated with adverse events.
"Case reports (e.g. Barrett & Pihl 2002; Coetzee, Kaminer & Morales 2002; Garland 1998; Jaffe 1991; Goyer, Davis & Rapoport 1979) and poison center reports (Klein-Schwartz 2003; Foley, Mrvos & Krenzelok 2000) suggest that individuals have used their own prescription stimulants for reasons other than what was intended by the prescribing clinician. "
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to examine the prevalence and factors associated with the illicit use of prescription stimulants and to assess the relationship between the medical and illicit use of prescription stimulants among undergraduate college students. A Web survey was self-administered by a random sample of 9,161 undergraduate students attending a large public midwestern university in the spring of 2003. A total of 8.1% reported lifetime illicit use of prescription stimulants and 5.4% reported past year illicit use. The number of undergraduate students who reported illicit use of prescription stimulants exceeded the number of students who reported medical use of prescription stimulants for ADHD. The leading sources of prescription stimulants for illicit use were friends and peers. Multivariate logistic regression analyses revealed several risk factors for illicit use of prescription stimulants such as being male, White, member of a social fraternity or sorority, Jewish religious affiliation, and lower grade point average. All of these characteristics were also related to medically prescribed use of prescription stimulants. Those who initiated medically prescribed use of prescription stimulants for ADHD in elementary school were generally not at increased risk for illicit use of prescription stimulants or other drugs during college as compared to those who were never prescribed stimulant medication. The present study provides evidence that the illicit use of prescription stimulants is a problem among undergraduate college students, and certain subgroups appear to be at heightened risk.
[Show abstract][Hide abstract] ABSTRACT: The therapeutic use of methylphenidate for the management of attention-deficit hyperactivity disorder in children is increasing. As therapeutic use increases, the risk increases of unintentional overdoses, medication errors, and intentional overdoses caused by abuse, misuse, or suicide gestures and attempts. Side effects during therapy, which include nervousness, headache, insomnia, anorexia, and tachycardia, increase linearly with dose. Clinical manifestations of overdoses include agitation, hallucinations, psychosis, lethargy, seizures, tachycardia, dysrhythmias, hypertension, and hyperthermia. Methylphenidate tablets can be abused orally, or they can be crushed and the powder injected or snorted. Despite its abuse potential, there is disagreement regarding the extent to which methylphenidate is being diverted from legitimate use to abuse in preteens and adolescents.
Current Opinion in Pediatrics 05/2002; 14(2):219-23. DOI:10.1097/00008480-200204000-00013 · 2.53 Impact Factor
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