Exploring Methylphenidate-Induced Intraocular Pressure: A Cautionary Tale in Pediatric ADHD Management

Clin Neuropharmacol. 2024 Sep-Oct;47(5):141-142. doi: 10.1097/WNF.0000000000000603. Epub 2024 Aug 2.

Abstract

Objectives: This case report explores the intricate relationship between methylphenidate (MTX) use and increased intraocular pressure (IOP) in a pediatric patient with a preexisting history of eye disease. Despite existing literature presenting cases of IOP elevation linked to MTX, a significant gap remains in understanding nuanced risk factors.

Methods: This case study used patients' medical records and a comprehensive literature review.

Results: A 6-year-old girl with attention deficit hyperactivity disorder and a family history of eye conditions exhibited elevated IOP after 12 days of MTX use, prompting discontinuation. The patient successfully transitioned to atomoxetine with normalized IOP and improved attention duration.

Conclusions: Existing cases emphasize the potential link between sympathetic nerve activity and IOP elevation induced by central nervous system stimulants like MTX. Notably, the patient's high hyperopia contributed to the impact of MTX on IOP, suggesting the need for cautious use in susceptible individuals. This case underscores the importance of individualized treatment strategies, particularly in attention deficit hyperactivity disorder patients with family history and additional eye findings, emphasizing safety and comprehensive patient care.

Publication types

  • Case Reports

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Central Nervous System Stimulants* / adverse effects
  • Central Nervous System Stimulants* / therapeutic use
  • Child
  • Female
  • Humans
  • Intraocular Pressure* / drug effects
  • Methylphenidate* / adverse effects
  • Methylphenidate* / therapeutic use

Substances

  • Methylphenidate
  • Central Nervous System Stimulants