Add time:08/29/2019         Source:sciencedirect.com

Intravenous injection of crushed Ritalin (methylphenidate 10 mg) tablets has emerged as a current medical concern in New Zealand. We report the clinical features of four cases of methylphenidate toxicity arising from intravenous (IV) injection of crushed Ritalin tablets, and highlight concerns regarding this form of drug abuse. Two patients required intensive care management and one died approximately 10 hours after injection due to a ruptured cerebral aneurysm.Two other cases required management for a variety of clinical events including hyperpyrexia, coagulopathy and seizures. In the non-fatal cases, hyperpyrexia and tachycardia were the most consistent toxic effects noted. Hypertension was noted in only one of these cases but cannot be ruled out as the cause of the ruptured aneurysm in the one fatality. Emergency care providers are reminded of the abuse potential with this drug and the potential serious consequences of intravenous use.

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