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Methylphenidate is one of the most common treatments for children with ADHD, but it can also have severe side effects. The FDA has received 15 reports of priapism (prolonged and unwanted erections) that can cause permanent erectile dysfunction. Other serious side effects in children include growth delays, deadly cardiovascular events, psychiatric disorders, and more.

What is Methylphenidate?

Methylphenidate is a stimulant drug used to treat attention-deficit hyperactivity disorder (ADHD), which is one of the most common childhood brain disorders. Methylphenidate controls symptoms like distractibility, hyperactivity, emotional lability, short attention span, and impulsivity. In 2012, approximately 3.9 million patients received a prescription for methylphenidate or dexmethylphenidate.

Popular methylphenidate products:

Methylphenidate and Priapism

In a Safety Alert for Methylphenidate issued in December 2013, the U.S. Food and Drug Administration (FDA) is warning about a rare but serious side effect known as ischemic priapism. This emergency medical condition occurs when blood is trapped inside the penis, causing an unwanted and painful erection lasting 4 hours or more. It can cause extreme pain, swelling, and irreversible erectile dysfunction.

The FDA recommends special precautions for children on methylphenidate:

“Younger males, especially those who have not yet reached puberty, may not recognize the problem or may be embarrassed to tell anyone if it occurs.  All male patients and their caregivers should be taught the signs and symptoms of priapism and the importance of seeking immediate medical treatment if it occurs.”

Methylphenidate Heart Risks

Sudden death has been reported in children with heart defects who took stimulant drugs like methylphenidate for the treatment of ADHD. Therefore, methylphenidate generally should not be prescribed to patients with heart rhythm abnormalities, cardiomyopathy, heart defects, or other factors that increase vulnerability to cardiovascular side effects. Patients should also be monitored for sharp increases in blood pressure or heart rate.

Methylphenidate heart risks may include:

  • Hypertension (high blood pressure)
  • Heart rhythm is fast, uneven, or pounding
  • Cardiac arrhythmia or palpitations
  • Cardiomyopathy
  • Heart attack
  • Stroke
  • Sudden cardiac death
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