title: Unexpected interaction of methylphenidate (Ritalin) with anaesthetic agents.
abstract: We report difficulty with conscious sedation of a child taking methylphenidate for attention deficit disorder and possible delayed adverse interaction of ketamine and methylphenidate resulting in severe nausea, vomiting and dehydration. The effects of methylphenidate and its potential interactions with anaesthetic agents is discussed. We suggest that anaesthesiologists who provide sedation or anaesthesia to patients receiving methylphenidate be aware of the potential need for high sedative doses and the possibility of undesirable interactions.
authors.affiliation: Department of Anesthesia, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1009, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Ririe
authors.forename: K L
authors.initials: KL
authors.lastname: Ririe
authors.forename: N F
authors.initials: NF
authors.lastname: Sethna
authors.forename: L
authors.initials: L
authors.lastname: Fox
mesh_terms: D000778:Anesthetics, Dissociative / Q000009:adverse effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D016292:Procedural Sedation; D004347:Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007649:Ketamine / Q000009:adverse effects*; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects* / Q000627:therapeutic use; D008874:Midazolam / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000778:Anesthetics, Dissociative; D000697:Central Nervous System Stimulants; D006993:Hypnotics and Sedatives; D008774:Methylphenidate; D007649:Ketamine; D008874:Midazolam