Clinical characteristics and outcomes of pediatric methylphenidate intoxication: a five-year single-center study.

BACKGROUND

Methylphenidate is widely prescribed for attention-deficit/hyperactivity disorder, and its use has increased substantially in recent years. Although generally considered safe within therapeutic ranges, supratherapeutic ingestion may result in various systemic adverse effects. This study aimed to evaluate the demographic and clinical characteristics of children presenting with overdose ingestion and to identify potential factors associated with symptom development.

METHODS

We conducted a retrospective review of patients younger than 18 years who presented to a tertiary pediatric emergency department between January 1, 2020, and December 31, 2024, due to overdose ingestion. Demographic characteristics, psychiatric history, ingested dose, mode of exposure, clinical findings, emergency department course, and factors potentially associated with adverse effects were analyzed.

RESULTS

Thirty-two patients were included; 72% were female, and ingestion was intentional in 84%. The mean ingested dose was 5.7 mg/kg. Clinical symptoms developed in 41% of patients. The most frequent findings were tachycardia (38%), mild hypertension (34%), agitation (22%), and seizures (16%). Although most cases were mild and resolved within 12 h of observation, one toddler developed neuropsychiatric manifestations requiring close monitoring with full recovery within 48 h. No statistically significant association was observed between age, sex, gastrointestinal decontamination status, or reported ingested dose and the development of clinical symptoms (p > 0.05).

CONCLUSIONS

Pediatric methylphenidate intoxication is generally mild, but severe neuropsychiatric and cardiovascular effects may occur. Careful clinical monitoring remains essential.

TRIAL REGISTRATION: Not applicable.