10.10. Analysis.
Comparison 10 Patient reports/series: number of participants with non‐serious adverse events, Outcome 10 Urogenitial system.
| Urogenitial system | |
|---|---|
| Study | |
| Testicular failure | |
| Ramasamy 2014 | A case report of testicular failure possibly associated with chronic use of Methylphendiate. The patient was 20 years old with treatment duration of approximately 17 years with voluntary cessation a few years ago. Dosage varied with age. The patient's complaint was initially delayed puberty. He complained of high‐pitched voice, lack of libido, low energy level, chronic fatigue and poor erectile function. The patient was advised to begin testosterone supplementation. The patient described in the case study seemed to exhibit characteristics related to the effects of chronic use of methylphenidate on development of human reproductive function. The unknown effects of methylphenidate are currently being studied, but as can be seen, one should exercise caution and patients should be followed closely when prescribing methylphenidate. However, because the developmental changes that occurred in the human participant occurred over a number of years of treatment with methylphenidate, there is very little information about the patient's condition and how it developed during that period of time |
| Sexual adverse events | |
| Coşkun 2009b | Case 1: Treated with 10‐30 mg/day of immediate‐release methylphenidate and experienced initial headache and nausea. Treated with 18 mg/day osmotic‐controlled release oral delivery system (OROS) methylphenidate and experienced emotional side effects (sense of nervousness in the chest, occasional emotional numbing), multiple daily erections (unrelated to sexual stimuli, painless and without ejaculations), occurring a few hours after ingesting methylphenidate and lasting 5‐10 minutes. No erections unrelated to sexual stimuli during a 1‐week medication‐free period. With re‐administration of 35 mg/day OROS methylphenidate for 3 weeks, experienced re‐emergence of erections of a longer duration compared with 18 mg/day of OROS methylphenidate, headache, nausea, and the same emotional side effects. No erections on drug‐free days, and no erections with discontinuation of medication. Case 2: Treated with 18 mg/day of OROS methylphenidate and experienced loss of appetite, headache, abdominal pain, sleep problems, and conjunctival injection. Headache and abdominal pain almost disappeared after 1 week. Also experienced hypersexual behaviours, with morning erections lasting 1 hour before ingestion of methylphenidate, and a weight loss of 1.5 kg within 2 months. On drug‐free days had almost no hypersexual behaviour during the day and no erection the following morning. When treated with 10‐20 mg/day of immediate‐release methylphenidate, morning erections and hypersexual behaviours decreased dramatically, sleep and appetite problems improved mildly, and there was no conjunctival injection (after three weeks). There were, however, possible withdrawal symptoms (increased irritability and hyperactivity, getting tearful easily), several hours after each dosage. Had no morning erections or hypersexual behaviours with discontinuation of OROS methylphenidate |
| Incontinence | |
| Tang 2010 | Side effects reported by the mother: IR‐MPH, 10 mg, no side effects. OROS‐MPH, 18 mg/d, no side effects. OROS‐MPH, 36 mg/d, double incontinence; stool incontinence (every day, frequent during daytime) and urinary incontinence (almost every day). The double incontinence completely resolved rapidly after the discontinuation of OROS methylphenidate 36 mg |
| Enuresis | |
| Ghanizadeh 2008b | A case report of nocturnal enuresis during MPH treatment Non‐serious adverse events MPH, titrated to 20 mg/day: Nocturnal enuresis Discontinuation of MPH: enuresis stopped immediately MPH, when titrated to 20 mg/day: Immediate re‐occurence of nocturnal enuresis Discontinuation of MPH: enuresis stopped immediately MPH, when titrated to 20 mg/day: Immediate re‐occurence of nocturnal enuresis Discontinuation of MPH: enuresis stopped immediately |
| Williamson 2011 | Two case reports showing resolution of enuresis when treated with MPH |