Ghadrdan Elliyeh, Mousavi Maryam, Ghaeli Padideh
Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Psychiatry. 2018 Oct;13(4):310-313.
Methylphenidate, a stimulant, is prescribed commonly in the treatment of attention deficit hyperactivity disorder (ADHD) in children and adults. Methylphenidate is generally considered a safe medication, however, some rare adverse effects, such as psychotic symptoms, may occur with its therapeutic or high doses. Additionally, this medication has a potential of abuse, especially among teenagers. There are several published cases regarding methylphenidate-induced psychosis in young adults. However, psychosis due to methylphenidate has been rarely reported in the elderly. This case presents psychotic manifestations due to methylphenidate in a 65-year-old female who was taking this medication for ADHD. She consumed 3 to 4 methylphenidate hydrochloride tablets per day for several months and thought that they were sleeping pills. Antipsychotic medication was initiated and methylphenidate was discontinued which resulted in improvement of her psychosis. Alternative diagnoses, including bipolar mood disorder with psychotic feature or mood disorder due to general medical condition, were ruled out because her psychotic symptoms appeared after taking several methylphenidate tablets and disappeared after discontinuation of this medication.
哌甲酯是一种兴奋剂，常用于治疗儿童和成人的注意力缺陷多动障碍（ADHD）。哌甲酯通常被认为是一种安全的药物，然而，在其治疗剂量或高剂量使用时，可能会出现一些罕见的不良反应，如精神症状。此外，这种药物有被滥用的可能性，尤其是在青少年中。有几例关于哌甲酯致年轻成人精神病的病例已发表。然而，老年人因哌甲酯导致的精神病很少被报道。本病例报告了一名65岁女性因服用哌甲酯治疗ADHD而出现精神病性表现。她连续数月每天服用3至4片盐酸哌甲酯片，且误认为这些是安眠药。开始使用抗精神病药物并停用哌甲酯后，她的精神病症状得到改善。排除了其他诊断，包括伴有精神病性特征的双相情感障碍或由躯体疾病所致的心境障碍，因为她的精神病症状在服用几片哌甲酯片后出现，并在停药后消失。
