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Unexpected interaction of methylphenidate (Ritalin) with anaesthetic agents
D G Ririe1, K L Ririe, N F Sethna
1Department of Anesthesia, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1009, USA.
Insights
Conscious sedation may be difficult in children taking methylphenidate for attention deficit disorder. Delayed interactions between ketamine and methylphenidate can cause severe nausea, vomiting, and dehydration.
Area of Science:
- Anesthesiology
- Pediatric Pharmacology
Background:
- Methylphenidate is commonly prescribed for attention deficit disorder (ADD).
- Anesthetic agents are frequently used for procedures in pediatric patients.
Abstract:
We report difficulty with conscious sedation of a child taking methylphenidate for attention deficit disorder and possible delayed adverse interaction of ketamine and methylphenidate resulting in severe nausea, vomiting and dehydration. The effects of methylphenidate and its potential interactions with anaesthetic agents is discussed. We suggest that anaesthesiologists who provide sedation or anaesthesia to patients receiving methylphenidate be aware of the potential need for high sedative doses and the possibility of undesirable interactions.