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Assessment of potential cardiovascular risks of methylphenidate in comparison with sibutramine: do we need a SCOUT (trial)?
Abstract With the recent approval of methylphenidate (MPH) for treating attention-deficit/hyperactivity disorder (ADHD) in adults, the number of patients exposed will increase tremendously. The ongoing debate on the cardiovascular safety of MPH has triggered two large retrospective cohort studies in children and adolescents as well as in young to middle-aged adults. These studies looked into serious cardiovascular events (sudden cardiac death, acute myocardial infarction and stroke) as primary endpoints and concluded that MPH was safe after a mean duration of 2.1 years of follow-up in children and adolescent...
Source: European Archives of Psychiatry and Clinical Neuroscience - March 17, 2015 Category: Neuroscience Source Type: research

The spontaneously hypertensive rat/Izm (SHR/Izm) shows attention deficit/hyperactivity disorder-like behaviors but without impulsive behavior: Therapeutic implications of low-dose methylphenidate.
In this study, ADHD-like behaviors in SHR/Izm were evaluated compared to Wistar rats. SHR/Izm showed high locomotor activity in the habituation phase in a novel environment, although locomotor activity in the initial exploratory phase was low. In a behavioral test for attention, spontaneous alternation behavior in the Y-maze test was impaired in SHR/Izm. However, impulsive behavior in the elevated-plus maze test, which is designed to detect anxiety-related behavior but also reflects impulsivity for novelty seeking, was comparable to Wistar rats. Hyperactivity and inattention, detected as ADHD-like behaviors in SHR/Izm, wer...
Source: Behavioural Brain Research - August 20, 2014 Category: Neurology Authors: Kishikawa Y, Kawahara Y, Yamada M, Kaneko F, Kawahara H, Nishi A Tags: Behav Brain Res Source Type: research

Intravenous methylphenidate: an unusual way to provoke ST-elevation myocardial infarction
Acute ST-T elevation is a sign of myocardial ischemia or infarction usually due to coronary artery atherosclerosis or coronary spasm. Coronary spasm may be spontaneous or can occur as a result of a drug that causes arterial spam. Ritalin, Novartis Pharmaceut. Corporation, USA (methylphenidate hydrochloride), a dopamine reuptake inhibitor, is an oral drug used to treat attention-deficit/hyperactivity disorder and narcolepsy. Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual dose for attention-deficit/hyperactivity disorder [1].
Source: The American Journal of Emergency Medicine - August 7, 2014 Category: Emergency Medicine Authors: Emile Hay, Vitaly Shklovski, Yossef Blaer, Vladimir Shlakhover, Amos Katz Tags: Case Report Source Type: research

Myocardial injury in a 41-year-old male treated with methylphenidate: a case report
Conclusions: When interpreting troponin results it is important to take into account the context of the patient's clinical presentation, including the possibility of adverse drug reactions. The adverse drug reaction could include a combination of vasospasm and/or increased oxygen demand due to tachycardia. This case should be borne in mind before a diagnosis of myocardial infarction is given, or a decision to perform invasive coronary angiography is made in patients that use methylphenidate or related substances. Cardiac magnetic resonance imaging could be of diagnostic value in such cases.
Source: BioMed Central - July 29, 2014 Category: Journals (General) Authors: Lisa Drange HoleJan Schjøtt Source Type: research

Pharmacological interventions for depression in people with traumatic brain injury: systematic review
Conclusion Some pharmacological interventions appear to improve depressive symptoms, anxiety symptoms and quality of life in people with depression and traumatic brain injury. However, the evidence is limited. There is a paucity of evidence for the effectiveness of other pharmacological interventions used in depression in this particular patient group.
Source: Journal of Neurology, Neurosurgery and Psychiatry - July 9, 2014 Category: Neurosurgery Authors: Vattakatuchery, J., Lathif, N., Joy, J., Cavanna, A., Rickards, H. Tags: Neurological injury, Stroke, Trauma CNS / PNS, Mood disorders (including depression), Trauma, Injury POSTER ABSTRACTS Source Type: research

The use of stimulant medications for non-core aspects of ADHD and in other disorders.
Abstract Psychostimulants play a central role in the management of ADHD. Here we review the evidence pertaining to the use of methylphenidate, dexamphetamine and related amphetamine salts, the prodrug lisdexamfetamine and modafinil for the management of comorbid ADHD and non-ADHD indications. There is a growing consensus that stimulant medications are helpful at improving the emotional dysregulation and lability, and oppositional and conduct symptoms that are often associated with ADHD. There is some evidence that psychostimulants may improve outcomes in those with treatment resistant depression, reduce negative s...
Source: Neuropharmacology - June 18, 2014 Category: Drugs & Pharmacology Authors: Sinita E, Coghill D Tags: Neuropharmacology Source Type: research

Adult onset methylphenidate induced dyskinesia after stroke
Methylphenidate is a stimulant medication that is commonly used to treat attention-deficit/hyperactivity disorder (ADHD). It is also used as adjuvant therapy for improving disability after stroke. Recently, Moreau et al. reported that methylphenidate improved gait hypokinesia and freezing in patients with advanced Parkinson's disease (PD) . The most common side effects of methylphenidate are; insomnia, anorexia, weight loss, abdominal pain, headache, irritability, anxiety, tachycardia, hypertension, and motor tics. Dyskinesia as a side effect of methylphenidate is rare, and only a few cases have been reported . Most of th...
Source: Parkinsonism and Related Disorders - April 14, 2014 Category: Neurology Authors: Jeong Yeon Kim, Jong Sam Baik Tags: Letters to the Editor Source Type: research

Aberrant CaMKII activity in the medial prefrontal cortex is associated with cognitive dysfunction in ADHD model rats.
Abstract Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous neurobehavioral disorder accompanied by cognitive and learning deficits, which is prevalent among boys. Juvenile male stroke-prone spontaneously hypertensive rats (SHRSP) exhibit ADHD-like behaviors including cognitive deficits and represent one animal model of ADHD. Here, we define a mechanism underlying cognitive dysfunction observed in SHRSP. Acute methylphenidate (MPH: 1mg/kg, p.o.) administration to SHRSP significantly improved not only inattention in a Y-maze task but also cognitive dysfunction in a novel object recognition test. Int...
Source: Brain Research - February 19, 2014 Category: Neurology Authors: Yabuki Y, Shioda N, Maeda T, Hiraide S, Togashi H, Fukunaga K Tags: Brain Res Source Type: research

Cardiovascular risks and management during Attention Deficit Hyperactivity Disorder treatment with methylphenidate.
Abstract Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common of the pediatric neuropsychiatric disorders. Methylphenidate is an important element of therapeutic strategies for ADHD. Clinicians are interested in the safety of methylphenidate. Because this drug raises heart rate and blood pressure, concerns have been raised about its cardiovascular safety. Concerns were based on case reports of sudden cardiac death in methylphenidate users, plausible pharmacological pathways involving well-established stimulant effects on heart rate and blood pressure. Until recently, data were limited to a num...
Source: Archives de Pediatrie - December 2, 2013 Category: Pediatrics Authors: Bange F, Le Heuzey MF, Acquaviva E, Delorme R, Mouren MC Tags: Arch Pediatr Source Type: research

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