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Journal of Child Neurology
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*METHYLPHENIDATE
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Methylphenidate Induction of Complex Visual Hallucinations

Ayelet Halevy, MD

Department of Neurology, Schneider Children's Medical Center of Israel, Petach Tikvah

Avinoam Shuper, MD

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel, avinoams{at}clalit.org.il

A 15-year-old boy with attention-deficit hyperactivity disorder (ADHD) presented with complex visual hallucinations of rats running around and touching and smelling him soon after receiving a first low dose of methylphenidate. The hallucinations resolved upon discontinuation of the drug. Reintroduction of the drug 7 years later at an even lower dose had the same effect. Other cases of vivid complex hallucinations of living creatures associated with methylphenidate have been reported in the literature. The pathogenetic mechanism is still unknown. In our case, the occurrence of hallucinations after a very low dose of the drug on 2 occasions may suggest an idiosyncratic reaction. The phenomenon might also be explained by a drug-induced dysfunction of the monoamine transmitters. Given the wide use of methylphenidate, clinicians should be aware of this possible side effect.

Key Words: methylphenidate • visual hallucinations • adverse reaction • attention-deficit hyperactivity disorder

This version was published on August 1, 2009

Journal of Child Neurology, Vol. 24, No. 8, 1005-1007 (2009)
DOI: 10.1177/0883073808331357
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