Ramasamy 2014.

Methods	A patient report of testicular failure possibly associated with chronic use of methylphenidate
Participants	Diagnosis of ADHD: DSM III‐R Age: 20 years old IQ: an exact number cannot be discerned but it is likely that the participant exhibits a normal IQ without any sort of disability Sex: male Ethnicity: Latino Country: USA Comorbidity: none Comedication: none Sociodemographics: family history was unremarkable
Interventions	Methylpenidate type: not stated Methylphenidate dosage: varied with age Administration schedule: not stated Duration of treatment: approximately 17 years with voluntary cessation a few years ago Treatment compliance: not stated
Outcomes	Serious adverse events: 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 results of laboratory tests were consistent with the patient's idiopathic testicular failure and warranted further exploration of the link between chronic methylphenidate use and effects on reproductive parameters
Notes	Key conclusions of the study authors: the patient described in our 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 Comments from the study authors: because the developmental changes that occurred in the 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 Comments from the review authors: this case has been included although the patient is 20 years old since he had been taking methylphenidate for approximately 17 years Funding/vested interest/authors' affiliations: no competing interests were disclosed Grant information: Ranjith Ramasamy is an NIH K12 Scholar supported by a Male Reproductive Health Research Career (MHRH) Development Physician‐Scientist Award (HD073917‐01) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Program Supplemental information regarding ADHD diagnosis and type, comorbidity and comedication received through personal email correspondence with the authors in April 2016 (Pranav 2016 [pers comm])