Evaluation of acute cardiovascular effects of immediate-release methylphenidate in children and adolescents with Attention Deficit Hyperactivity Disorder

Introduction Attention-Deficit Hyperactivity Disorder (ADHD) is a frequent condition in children and often extends into the adult years. Commonly prescribed treatments include stimulant drugs, such as methylphenidate (MPH) and amphetamines, along with atomoxetine. Stimulants have been associated with increased cardiovascular risk, due to rise in blood pressure and heart rate (HR). Further, the Immediate Release (IR) MPH has aroused concerns about potential cardiovascular adverse-effects in the early hours after administration. This study was performed to investigate acute effects of IR-MPH on ECG in pediatric population. Methods A total of 40 consecutive patients with ADHD (M 38/F 2 mean age 11.43±2.51 range 7,6-17,10), receiving a new prescription of MPH, underwent a standard ECG before and after two hours from the administration of IR-MPH 10 mg per os. Basal and post-treatment ECG parameters, including mean QT (QTc) and QT dispersion (QTd) interval duration, were compared. RESULTS: Significant modifications of both QTc and QTd values were not found after drug administration. QTd fluctuated slightly from 25.66±12.44 ms to 26.28±8.73 ms; QTc moved from 404.10±16.71 ms to 402.07.3±13.02 ms. Maximum QT interval duration decreased from 415±16.9 ms to 413.7±14.24 ms, while minimum QT from 389.52±17.58 ms to 387.42±13.82 ms. HR moved from 78±15.36 bpm to 80.6±19.13 bpm. CONCLUSIONS: The findings of this study show no significant changes in ECG parameters in the early hours after IR-MPH administration.