Central nervous system: mood disorders
Study
Depression and disturbed mood
Hechtman 2011	A case report about a 5‐year‐old boy. MPH use for around a year. Reported non‐serious adverse events. In late afternoon and early evening, he became very emotional, with frequent crying, marked irritability and many tantrums. The emotional side effects subsided after he discontinued methylphenidate treatment
Mino 1999	3 weeks after starting on 10 mg/day of methylphenidate, the mother reported by telephone that the patient seemed depressed. The dose of methylphenidate was reduced to 5 mg/day. A week later the patient visited the clinic. The therapist diagnosed her condition as a depressive state and discontinued methylphenidate. 6 weeks after discontinuation of methylphenidate, she was diagnosed with a schizophrenic‐like psychotic state, due to symptoms of delusions of reference and persecution, delusional mood, silly smile and thought block. There was no evident hallucination. The patient took antipsychotic medication for 2 months and her psychotic symptoms disappeared
Niederhofer 2009	An 11‐year‐old boy received 20 mg/day of methylphenidate for 2 months, which led to depressed mood and appetite loss
Irritability
Hechtman 2011	A case report about a boy, who became very emotional, with frequent crying episodes, marked irritability and many tantrums when treated with methylphenidate; methylphenidate was used for around a year
Sabuncuoglu 2007	3 case reports of hyperactivity and irritability during switch from risperidone to methylphenidate Case 1: Methylphenidate introduced 2 days after abrupt discontinuation of 1 mg/day of risperidone (8 months), and produced agitation, irritability, vigilance, and violent behavior. No dyskinetic movements. Methylphenidate was discontinued and the adverse events disappeared. After a 6‐week long, drug‐free period, methylphenidate was reintroduced at 15 mg/day. No adverse events were observed Case 2: Methylphenidate introduced after discontinuation of 1 mg/day of risperidone (2 years), and produced a near manic state, irritability, agitation, racing thoughts, and distractibility. No dyskinetic movements. Methylphenidate was discontinued and the adverse events disappeared. After a couple of months, methylphenidate was reintroduced at 15 mg/day and was well‐tolerated Case 3: Methylphenidate introduced after a 1‐week medication‐free interval after treatment with 1 mg of risperidone, and produced irritability, agitation and discomfort. Methylphenidate was discontinued and the adverse events disappeared. The patient did not retry the medication Key conclusions of the study authors: This report of 3 patients draws attention to a unique condition that arises in switching from an atypical antipsychotic to stimulant medication. A drug‐free interval is recommended in switching from risperidone to methylphenidate
Aggression
Coignoux 2009	A case report of a 14‐year‐old boy receiving methylphenidate for 2 years who developed gestural stereotypies and verbal aggressiveness towards his parents whilst on methylphenidate treatment
Niederhofer 2011	A case series describing adverse effects (xerostomia, aggression and emotional instability) among children taking methylphenidate
Mania/euphoria
Corrigall 1996	A case report of methylphenidate euphoria in an 11‐year‐old boy diagnosed with hyperkinetic disorder Key conclusions of the study authors: Methylphenidate euphoria can occur in young prepubertal children and this may lead to abuse of medication
Ghanizadeh 2009	Mother and nursery teacher complained about increased hyper‐talkativity starting about 45 minutes after taking medication. The increased hyper‐talkativity continued for about 3–4 hours. They scored the hyper‐talking as 7–9 on a 1–10 visual analogue scale. Re‐challenge was conducted many times (more than 20 times) and hyper‐talking reoccurred after every time he took the medication