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Severe toxicity due to injected but not oral or nasal abuse of methylphenidate tablets.
MedLine Citation:
PMID:  21984207     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Non-medical use of methylphenidate is increasing. Little is known about potential acute medical complications associated with recreational use of methylphenidate.
STUDY AIM: To identify medical problems associated with methylphenidate abuse.
METHODS: Retrospective case series of methylphenidate abuse cases presenting to an inner city emergency department.
RESULTS: We identified 14 cases of methylphenidate abuse between 2003 and 2010. Ten of these patients abused methylphenidate alone while four co-ingested other drugs, mainly alcohol. The route of ingestion was oral in nine patients, nasal in one and intravascular in four. Severe toxicity was exclusively observed in users who injected the drug. Two cases involved accidental intra-arterial injection and resulted in tissue necrosis leading to the amputation of a forearm and of fingertips, respectively. Clinical findings in the non-serious cases included mild to moderate symptoms and signs of sympathetic nervous stimulation such as agitation, tachycardia, hypertension, anxiety, hallucination, headache, tremor and dizziness. Nine of the fourteen patients were taking methylphenidate as a prescribed drug. Eight patients were former or current multiple substance abusers.
CONCLUSION: Methylphenidate misuse is not a significant burden for emergency departments in Switzerland. Oral and nasal administration of methylphenidate did not result in severe toxicity. However, injection of crushed methylphenidate pills lead to serious local toxicity. Most patients with methylphenidate abuse had a prescription for the drug indicating deviation from medical use. A history of multiple substance use may be a risk factor for non-medical use of methylphenidate.
Authors:
M Bruggisser; M Bodmer; M Liechti
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Publication Detail:
Type:  Journal Article     Date:  2011-10-09
Journal Detail:
Title:  Swiss medical weekly     Volume:  141     ISSN:  1424-3997     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2011  
Date Detail:
Created Date:  2011-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  w13267     Citation Subset:  IM    
Affiliation:
University Hospital Basel, Hebelstrasse 2, 4031 Basel, CH.
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