Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Metilfenidat Kullanımına Bağlı Erken Kardiyovasküler Değişikliklerin Değerlendirilmesi

Objective: Some cardiovascular side effects can be seen in patients receiving methylphenidate treatment with a diagnosis of attention deficit and hyperactivity disorder (ADHD), although not frequent. There are few studies in the literature conducted in these patients about this issue. We aimed to investigate the early effects of methylphenidate on the cardiovascular system in children with ADHD in this study.  Material and Methods: We analyzed 141 patients receiving methylphenidate treatment for ADHD in the pediatric psychiatry clinic of our hospital between May 2011 and May 2012. We retrospectively evaluated the demographic characteristics, heart rate, systolic and diastolic blood pressures, QTc duration at electrocardiogram (ECG) and 24-hour rhythm Holter results of thirty patients who had cardiovascular symptoms in the first month of treatment.  Results: We evaluated a total of 30 patients (8 female and 22 male) with a mean age of 10±3 years for females and 9±2.2 years for males. The mean QTc duration increased at the end of the first month of treatment and the change was statistically significant. However, no patient had pathological prolongation of QTc duration. Although the mean systolic and diastolic blood pressures increased in female patients at the end of first month, this increase was not statistically significant. Similarly, there was an increase in the mean heart rates of the patients at the end of first month, but it was not statistically significant. The main symptoms of the patients were palpitation in 14 patients (46, 6%), chest pain in 10 patients (33.4%), palpitation and chest pain in 4 patients (13,4%) and dyspnea in 2 patients (6.6%). ECG and 24-hour rhythm Holter monitoring findings were normal in all patients. However, methylphenidate treatment was terminated in two patients because of the request of their families despite completely normal test results.  Conclusion: This study was performed to demonstrate the early effects of methylphenidate treatment on the cardiovascular system in ADHD patients. This treatment caused prolongation of QTc duration, which was statistically significant but within normal ranges.