Gracious 1999.

Methods	A patient report of atrioventricular nodal re‐entrant tachycardia during stimulant treatment
Participants	Diagnosis of ADHD: DSM‐IV (subtype: not stated) Age: 13 years old IQ: > 70 Sex: female Ethnicity: African American Country: USA Comorbidity: obsessive compulsive disorder and dysthymia Comedication: 50 mg/day sertraline Sociodemographics: not stated
Interventions	First prescription Methylphenidate type: not stated Methylphenidate dosage: 30 mg Administration schedule: twice daily: morning and noon Duration of treatment: 3 months Treatment compliance: noncompliant with the afternoon dose Second prescription Methylphenidate type: sustained release methylphenidate Methylphenidate dosage: 20 mg Administration schedule: once daily: morning Duration of treatment: 11 months Treatment compliance: intermittently compliant
Outcomes	First prescription No serious or non‐serious adverse events reported Second prescription Serious adverse events: After 5 months of treatment; 2 15‐minute episodes of chest pain, associated with tingling in her fingers and shortness of breath. Heart rate: 96. Blood pressure: 155/79. 1 month later chest pain, shortness of breath, sweating, and palpitations beginning during urination. Heart rate: 100 No cardiac complaints in the following 5 months
Notes	Funding/vested interests: none Authors' affiliations: Division of Child Psychiatry, Case Western Reserve University, University Hospitals of Cleveland, Cleveland, Ohio Key conclusions of the study authors: stimulant medication may evoke onset of atrioventricular nodal tachyarrhythmias in patients who have the potential to develop them, possibly in combination with a selective serotonergic reuptake inhibitor Comments from the study authors: the cardiologist consulted believed this patient had a structural vulnerability of genetic etiology for the arrhythmia which was then precipitated by the stimulant Supplemental information regarding ADHD diagnostic criteria and IQ received through personal email correspondence with the authors in October 2013 (Gracious 2013 [pers comm])