Seizures methylphenidate

Seizures Methylphenidate may lower the convulsive threshold in patients with history of seizures, in patients with prior EEG abnormalities in the absence of a history of seizures, and, very rarely, in the absence of a history of seizures and no prior EEG evidence of seizures. In the presence of seizures, discontinue the drug. Hypertension and other cardiovascular conditions Use cautiously in patients with hypertension. Monitor blood pressure at appropriate intervals in all patients taking dexmethylphenidate, especially those with hypertension. Caution is indicated in treating patients whose underlying medical conditions might be compromised by increases in blood pressure or heart rate (eg, pre-existing hypertension, heart failure, recent Ml, hyperthyroidism). 

Seizure disorders Methylphenidate may lower the seizure threshold in patients with a history of seizures, with prior EEG abnormalities in absence of seizures, and, very rarely, in the absence of history of seizures and no prior EEG evidence of seizures. 

A child with attention-deficit hyperactivity disorder [ADHD] and conduct disorder is treated with 45 mg/d of methylphenidate and 2 mg/d of risperidone. A new diagnosis of complex partial seizures is made and the child is started on carbamazepine. About 10 days after the initiation of carbamazepine, the child develops withdrawal dyskinesias of mouth and tongue. After discontinuation of carbamazepine, the movements last for 1 week. 

There is large variation in individual responses to methylphenidate among hyperactive children with minimal brain dysfunction. It is therefore advisable to start with small divided doses, since some sjmptoms (extrapjr-amidal and seizure-like) could be dose-related. 

Amphetamines—contraindicated with MAOIs Methylphenidate (Ritalin)— contraindicated with MAOIs Seriously elevated blood pressure (hypertensive crisis), elevated temperature, seizures, cerebral hemorrhage, death... 

Methylphenidate should not be used with monoamine oxidase inhibitors such as tranylcypromine. Symptoms of overdose may include euphoria, confusion, delirium, coma, toxic psychosis, agitation, headache, vomiting, dry mouth, mydriasis, self-injury, fever, diaphoresis, tremors, hyper-reflexia, muscle twitching, seizures, flushing, hypertension, tachycardia, palpitations, and arrhythmias. 

Amphetamines methylphenidate cocaine Agitation, hypertension, tachycardia, delusions, hallucinations, hyperthermia, seizures, death Apathy, irritability, increased sleep time, disorientation, depression... 

Serum levels of clonazepam are decreased by the enzyme-inducing properties of phenobarbitai, phenytoin, and CBZ. Concurrent administration of amphetamines, methylphenidate, ethanol, antianxiety drugs, or antipsychotics may cause CNS depression or altered respiration. The combined administration of clonazepam and valproate may cause absence status, and in patients displaying a mixed seizure pattern, clonazepam may precipitate grand mal seizures. 

A 14-year-old boy taking methylphenidate 60 mg daily was additionally given bupropion 200 mg increased to 300 mg daily. The patient experienced grand mal seizures 4 weeks after the dosage increase, but remained seizure-free onee the bupropion was discontinued. Another report describes aeute myoeardial infarction in a 16-year-old boy associated with methylphenidate, bupropion and erythromycin. It was proposed that the erythromyein might have eaused elevated levels of bupropion leading to a... 

Ickowicz A Bupropian-methylphenidate combination and grand mal seizures. Can JPsychiatry... 

Isolated reports describe delirium in one patient and a seizure in another when methylphenidate was taken with sertraline. Schizophrenia and symptoms of amfetamine toxicity have also been reported in two patients taking amfetamine and fluoxetine. There is an isolated report of the serotonin syndrome associated with concurrent citalopram and dexamfetamine and another associated with sertraline and etilefrine. There is also a report of adverse effects associated with fluoxetine and phenylpropanolamine. 

An isolated report describes a tonic-clomc seizure in a 13-year-old boy after he had been taking sertraline 25 to 50 mg daily and methylphenidate 80 mg daily for about 2 weeks. He had been receiving methylphenidate without significant adverse effects for about 10 months before the seizure and following discontinuation of the sertraline experienced no further seizures. ... 

Methylphenidate is considered safe for children who are seizure free. However, a few reports of seizure aggravation in methylphenidate-treated children with uncontrolled epilepsy have raised concerns about its use in this group [61 ]. 

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