Hallucinations during methylphenidate therapy

Abstract

Methylphenidate (MPH) is the medication of choice for attention deficit hyperactivity disorder (ADHD), administered to millions of children with minimal side effects.1 The appearance of hallucinations at therapeutic doses of MPH has rarely been reported.1,2⇓ We describe three children with ADHD, who were treated with low doses of MPH and developed complex visual and haptic hallucinations. The causal role of MPH in the development of hallucinations was based on their appearance after ingestion of the drug, resolving after its withdrawal, and the absence of psychiatric comorbidity that could explain such phenomena. In one patient, the hallucinations reappeared after an inadvertent rechallenge. ### Case 1. A 7-year-old adopted boy with ADHD and oppositional defiant disorder was treated with MPH, 0.3 mg/kg (7.5 mg), once daily. After 1 year of treatment, he reported seeing and feeling snakes crawling on and around him starting 1 hour after drug ingestion. The teaching staff assumed an emotional …