Evaluation Of Acute Cardiovascular Effects Of Immediate-Release Methylphenidate In Children And Adolescents With Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder is a frequent condition in children and often extends into adulthood. Use of immediate-release methylphenidate (MPH) has raised concerns about potential cardiovascular adverse effects within a few hours after administration. This study was carried out to investigate acute effects of MPH on electrocardiogram (ECG) in a pediatric population. A total of 54 consecutive patients with attention-deficit hyperactivity disorder (51 males and 3 females; mean age =12.14 +/- 2.6 years, range 6-19 years), receiving a new prescription of MPH, underwent a standard ECG 2 hours before and after the administration of MPH 10 mg per os. Basal and posttreatment ECG parameters, including mean QT (QT interval when corrected for heart rate [QTc]), QTc dispersion (QTd) interval duration, T-peak to T-end (TpTe) intervals, and TpTe/QT ratio were compared. Significant modifications of both QTc and QTd values were not found after drug administration. QTd fluctuated slightly from 25.7 +/- 9.3 milliseconds to 25.1 +/- 8.4 milliseconds; QTc varied from 407.6 +/- 12.4 milliseconds to 409.8 +/- 12.7 milliseconds. A significant variation in blood pressure (systolic blood pressure 105.4 +/- 10.3 vs 109.6 +/- 11.5; P < 0.05; diastolic blood pressure 59.2 +/- 7.1 vs 63.1 +/- 7.9; P < 0.05) was observed, but all the data were within normal range. Heart rate moved from 80.5 +/- 15.5 bpm to 87.7 +/- 18.8 bpm. No change in TpTe values was found, but a statistically significant increase in TpTe/QTc intervals was found with respect to basal values (0.207 +/- 0.02 milliseconds vs 0.214 +/- 0.02 milliseconds; P < 0.01). The findings of this study show no significant changes in ECG parameters. TpTe values can be an additional parameter to evaluate borderline cases.