Methylphenidate

Use in adults is an off-licensed indication for all brands of methylphenidate MR.

*Higher doses are prescribed under specialist supervision.

• Glaucoma
• Hyperthyroidism, thyrotoxicosis or phaeochromocytoma
• During treatment with non-selective, irreversible monoamine oxidase (MAO) inhibitors, or within a minimum of 14 days of discontinuing those drugs, due to the risk of hypertensive crisis
• Diagnosis or history of severe depression, anorexia nervosa/anorexic disorders, suicidal tendencies, psychotic symptoms, severe mood disorders, mania, schizophrenia, psychopathic/borderline personality disorder, or severe and episodic (Type I) Bipolar (affective) Disorder (that is not well-controlled)
• Pre-existing cardiovascular disorders including severe hypertension, heart failure, arterial occlusive disease, angina, haemodynamically significant congenital heart disease, cardiomyopathies, myocardial infarction, potentially life-threatening arrhythmias and channelopathies (disorders caused by the dysfunction of ion channels)
• Pre-existing cerebrovascular disorders cerebral aneurysm, vascular abnormalities including vasculitis or stroke

Very common: Headache, nervousness and insomnia.

Common: Abdominal pain, nausea and vomiting, drowsiness, dizziness, dyskinesia, rash and dry mouth, decreased appetite, changes in BP and heart rate (usually increased).

Less common: Anger, blurred vision, apathy, confusion, tics, worsening of pre-existing tics, psychotic disorders and mood changes.

See SPC for full details

XL/MR: modified release. IR: immediate release

Can be stopped abruptly with no need for gradual reduction.