Methylphenidate-Induced Visual Hallucinations

Abstract

An 11-year-old boy with attention deficit/hyperactivity disorder (ADHD) presented with visual hallucinations several years after starting methylphenidate (MPH). The hallucinations resolved upon discontinuation of the drug. Reports of toxic hallucinosis during treatment with MPH are rare. Although the pathogenetic mechanism is unclear, the occurrence of hallucinations may be explained by a chronic increase in synaptic dopamine. Clinicians should be aware of this possible rare adverse manifestation occurring at therapeutic doses.

Key words

methylphenidate - hallucinations - ADHD

References

• 1 Aguilera-Albesa S, Yoldi-Petri ME, Molins-Castiella T. et al . Alucinaciones tras la introducción de metilfenidato en dosis bajas [Hallucinations after methylphenidate introduction at low doses].  Rev Neurol. 2010;  51 254-255
• 2 Cherland E, Fitzpatrick R. Psychotic side effects of psychostimulants: a 5-year review.  Can J Psychiatry. 1999;  44 811-813
• 3 Curatolo P, Paloscia C, D’Agati E. et al . The neurobiology of attention deficit/hyperactivity disorder.  Eur J Paediatr Neurol. 2009;  13 299-304
• 4 Gross-Tzur V, Joseph A, Shalev RS. Hallucinations during methylphenidate therapy.  Neurology. 2004;  63 753-754
• 5 Halevy A, Shuper A. Methylphenidate induction of complex visual hallucinations.  J Child Neurol. 2009;  24 1005-1007
• 6 Lucas A, Weiss M. Methyphenidate hallucinosis.  JAMA. 1971;  217 1079-1081
• 7 Rashid J, Mitelman S. Methylphenidate and somatic hallucinations.  J Am Acad Child Adolesc Psychiatry. 2007;  46 945-946
• 8 Ross R. Psychotic and manic-like symptoms during stimulant treatment of attention deficit hyperactivity disorder.  Am J Psychiatry. 2006;  1149-1152
• 9 Tomas Vila M, Izquierdo Quevedo FJ, Cerdan Vera MT. et al . Alucinaciones visuales producidas por metilfenidato [Visual hallucinations caused by methylphenidate].  An Pediatr (Barc). 2010;  72 229-230
• 10 Wilens T, Pelham W, Stein M. et al . ADHD treatment with once-daily OROS methylphenidate: interim 12-month results from a long-term open-label study.  J Am Acad Child Adolesc Psychiatry. 2003;  42 424-433
• 11 Young JG. Methylphenidate-induced hallucinosis: case histories and possible mechanism of action.  J Dev Behav Pediatr. 1981;  35-38

Correspondence