title: Case report: intoxication with high dose of long-acting methylphenidate (Concerta(®)) in a suicidal 14-year-old girl.
abstract: A 14-year-old girl with suicidal ideation was presented to the paediatric hospital about 2 h after ingestion of 21 long-acting methylphenidate (MPH) 54-mg tablets (1,134 mg Concerta(®)). At admission signs of sympathomimetic syndrome were observed like agitation, visual hallucinations, slight hypertension, and sinus tachycardia. Treatment included prevention of absorption (30 g activated charcoal orally) and careful observation related to the overstimulation of the sympathic system. Despite the intake of charcoal, the serum concentrations of MPH were 107 and 93 ng/ml 2.5 and 22 h after ingestion of MPH tablets. No support of vital functions was necessary. The girl made a full recovery and was discharged after 3 days of care at the paediatric clinic and referred to the child and adolescent psychiatric department. Exposure to a huge overdose of long-acting MPH exhibited acute sympathomimetic toxicity but no life-threatening symptoms in this patient. Thus this case report suggests that patients intoxicated with high dose long-acting MPH formulations can recover without sequelae when managed properly.
authors: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Germany. klampfl@kjp.uni-wuerzburg.de
authors: K
authors: K
authors: Klampfl
authors: A
authors: A
authors: Quattländer
authors: R
authors: R
authors: Burger
authors: B
authors: B
authors: Pfuhlmann
authors: A
authors: A
authors: Warnke
authors: M
authors: M
authors: Gerlach
mesh_terms: D000293:Adolescent; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D003692:Delayed-Action Preparations / Q000493:pharmacokinetics / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D059020:Suicidal Ideation
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate