Methylphenidate suicide risk

The best-known products come from the amphetamine group (see Table 1.12) Dexedrine1 1 (generic name d-amphetamine) and Pervitin 1 (methamphetamine) were particularly used in the 1950s and 1960s as stimulants and also as appetite suppressants, but today play hardly any role in medical practice. Ritalin (methylphenidate) has some relevance its psychostimulant action is said to be weaker than that of amphetamines and it is apparent ) less abused than the latter. Because methylphenidate also possesses mild antidepressant activity, in some countries it is used to combat not only narcolepsy and ADHD but also mild depressions without suicide risk (Satel and Nelson, 1989). 

Most of the symptoms described in my previous publications and by the FDA in its new label are the result of activation or stimulation, a syndrome similar to that caused by stimulants such as amphetamine, methamphetamine, and methylphenidate, especially in high doses. Compared to antidepressant-induced suicidality, activation is bolstered by a much larger scientific literature and poses a far more common, and often disastrous, level of risk (see subsequent discussion). 

The process of beginning to reassess the risks of stimulants began in June 2005, when the FDA (2005d) first gave notice that it was receiving a large number of reports of adverse psychiatric reactions, including suicidality, for methylphenidate products such as Concerta and Ritalin ... 

In a study based on the UK General Practice Research Database (GPRD) in patients with ADHD, aged 2-21 years, from 1993 to 2006 with prescriptions for methylphenidate, dexamfetamine, or atomoxetine, there was no increase in the risk of sudden death but there was an increased risk of suicide [55 ]. Seven patients died in a cohort of 18 637 patient-years, and cause of death was obtained in six none was deemed to be a case of sudden death (incident rate ratio 1.63 95% Cl = 0.04, 9.71). The standardized mortality ratios for suicide were 162 (95% Cl = 20, 585) in patients aged 11-14 years and... 

---