[Methylphenidate-induced liver damage]

Drug-induced liver injury (DILI) is liver damage caused by medicines and accounts for approximately 15% of all cases of liver failure. Psychotropic drugs account for a significant proportion of the above group of medicines. The clinical presentation can range from an asymptomatic mild elevation of liver enzymes to severe hepatitis. We discuss the case of a 22-year-old patient who presented at a follow-up appointment at a psychiatric outpatient clinic with asymptomatic liver damage, one week after starting treatment with methylphenidate. A review of the literature shows that this rare side effect is caused by an idiosyncratic, dose-independent pathological mechanism in which the metabolism of methylphenidate plays a significant role. Blood tests at the start of treatment are recommended for early detection, particularly in high-risk patients.