Millions of children with ADHD take methylphenidate. Unfortunately, children are at risk of developing severe side effects like cardiovascular events and psychiatric disorders. In December 2013, the FDA also required drug-makers to add warnings about priapism, a rare side effect involving a prolonged erection (4 hours or more) that can cause permanent erectile dysfunction.
What is the problem with Methylphenidate?
Methylphenidate was prescribed to 3.9 million people in 2012, primarily for the treatment of attention-deficit hyperactivity disorder (ADHD). It comes in short-acting and extended-release formulations which may be taken once a day or multiple times. Methylphenidate controls symptoms like impulsivity, short attention span, hyperactivity, distractibility, and emotional lability.
List of methylphenidate ADHD medications:
- Methylin, Methylin ER
- Ritalin, Ritalin LA, Ritalin SR
- Metadate CD, Metadate ER
- Focalin, Focalin XR (dexmethylphenidate)
- Quillivant XR
- And more
Methylphenidate and Priapism (Long-Lasting Erection) May Cause Erectile Dysfunction
Methylphenidate has been associated with 15 cases of priapism between 1997 and 2012, according to a Safety Alert for methylphenidate. Although rare, priapism is a serious medical emergency that can cause severe tissue damage in the penis, swelling, excruciating pain, and permanent erectile dysfunction.
Some patients who had priapism from methylphenidate were hospitalized, and two needed surgery. Treatment may involve placement of a shunt to divert blood-flow, tying off ruptured arteries, or using a needle to drain blood from the corpus cavernosum.
Priapism can occur in males of any age, but there are particular safety concerns for children because they may not recognize symptoms or they may not tell an adult. Delaying treatment significantly elevates a child’s risk of suffering permanent impotence (erectile dysfunction).
Methylphenidate Side Effects
The most common side effects of methylphenidate include problems sleeping, loss of appetite, stomach ache, and headache. Methylphenidate can also exacerbate anxiety, tension, and agitation, which is why it is contraindicated in patients with these problems.
Methylphenidate side effects in children:
- Slow growth (height and weight)
- Changes in eyesight or blurred vision
- Priapism (erection lasting 4 hours or more)
- Psychiatric disorders
- New or worsening hostility, aggression, bipolar illness, manic symptoms, etc.
- Circulation problems in fingers and toes
- Cardiovascular events