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Updated: Jul 17, 2026
07:02
A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
Published on: February 11, 2019
[Sympathomimetic syndrome caused by autointoxication with methylphenidate]
L F D van Vulpen1, M M Malingré, R Lange
1Afd. Interne Geneeskunde, Meander Medisch Centrum, Postbus 1502, 3800 BM Amersfoort.
Nederlands Tijdschrift Voor Geneeskunde
|January 9, 2007
Summary
A man survived a massive overdose of methylphenidate (a stimulant) and alcohol. Prompt treatment with activated charcoal and supportive care led to a full recovery from this potentially lethal poisoning.
Area of Science:
- Toxicology
- Pharmacology
- Emergency Medicine
Background:
- Methylphenidate is a central nervous system stimulant commonly prescribed for ADHD.
- Co-ingestion of substances can complicate overdose management and prognosis.
Observation:
- A 31-year-old male presented after ingesting over 1000 mg of methylphenidate, 8000 mg of ibuprofen, and significant alcohol.
- Clinical signs included agitation, hallucinations, mydriasis, and sinus tachycardia, indicative of a sympathomimetic syndrome.
Findings:
- Toxicological analysis revealed a plasma-ethanol concentration of 0.27% and a peak serum-methylphenidate level of 176 µg/l.
- Toxic concentrations of ethylphenidate, an active metabolite, were also detected.
- The patient received activated charcoal and an oral laxative, followed by intensive care unit observation.
Implications:
- This case highlights the importance of prompt medical intervention in severe methylphenidate overdose.
- Management strategies include preventing further absorption, close monitoring of vital signs, and supportive care.
- The presence of ethylphenidate underscores the complex metabolism and potential toxicity of methylphenidate co-ingestion.
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