A young man with acute dilated cardiomyopathy associated with methylphenidate

Vasc Health Risk Manag. 2008;4(2):477-9. doi: 10.2147/vhrm.s2410.


An 18-year-old obese man with a body mass index of 40, diagnosed with attention-deficit hyperactivity disorder and treated with methylphenidate (Concerta) was acutely admitted to hospital with hypoxia and dyspnoea. On investigation signs of liver-, renal-, and heart-failure were found. Noradrenalin infusion was started. Echocardiography showed dilated left ventricle and an ejection fraction (EF) of 25%. Liver function improved, noradrenalin and dobutamine were tapered, but three days after admission a new echocardiography showed an EF of 10%. The patient was transferred to the National Hospital (Rikshospitalet, Oslo), where intensified treatment including intra aortic balloon pump (IABP) was instituted. Cardiac function improved, and 3 weeks later the IABP was disconnected. EF at this point was 15%. The patient was denied heart transplantation due to various cofactors. The investigation concluded with a probable relationship between his cardiomyopathy and the use of methylphenidate (Concerta).

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Cardiomyopathy, Dilated / chemically induced*
  • Cardiomyopathy, Dilated / physiopathology
  • Cardiomyopathy, Dilated / therapy
  • Central Nervous System Stimulants / adverse effects*
  • Dobutamine / therapeutic use
  • Humans
  • Intra-Aortic Balloon Pumping
  • Male
  • Methylphenidate / adverse effects*
  • Norepinephrine / therapeutic use
  • Obesity / complications
  • Stroke Volume
  • Sympathomimetics / therapeutic use
  • Treatment Outcome


  • Central Nervous System Stimulants
  • Sympathomimetics
  • Methylphenidate
  • Dobutamine
  • Norepinephrine