Clin Psychopharmacol Neurosci.  2019 Aug;17(3):446-449. 10.9758/cpn.2019.17.3.446.

Methylphenidate and Central Precocious Puberty: A Probable Side Effect among Seven Children with the Attention Deficit Hyperactivity Disorder

• Ergür AT
• Gül H
• Gül A

• KMID: 2457410
• DOI: http://doi.org/10.9758/cpn.2019.17.3.446

Abstract

Methylphenidate (MPH) is the most preferred drug for treatment of the attention deficit hyperactivity disorder (ADHD). Here, we aimed to discuss the possible effects and mechanisms of MPH on precocious puberty (PP) via a case series with seven children who had normal body mass index. In this case series we evaluated seven children with ADHD, who had received MPH for at least 6 months (0.5 mg/kg/dose three times a day, maximum 60 mg) and admitted to Department of Pediatric Endocrinology with PP symptoms. The mean age was 8.16 years. Basal hormonal levels (luteinizing hormone [LH], follicle stimulating hormone, and estrogen/testosterone) were within normal range. Results of LH-releasing hormone stimulation tests demonstrated central pubertal responses. Glutamine, dopamine and noradrenaline are most important excitatory neurotransmitters that have a role at the beginning of puberty. The effect of MPH, cumulating dopamine and noradrenaline in the synaptic gap could be associated with the acceleration of puberty with the excitatory effect of dopamine's gonadotropin-releasing hormone (GnRH) release, excitatory effect of noradrenaline's GnRH release and the disappearance of GnRH receptor expression suppressor effect on prolactin disinhibitory effect.

Keyword

Attention deficit hyperactivity disorder; Methylphenidate; Precocious puberty

MeSH Terms

Acceleration
Adolescent
Attention Deficit Disorder with Hyperactivity*
Body Mass Index
Child*
Dopamine
Endocrinology
Follicle Stimulating Hormone
Glutamine
Gonadotropin-Releasing Hormone
Humans
Methylphenidate*
Neurotransmitter Agents
Norepinephrine
Prolactin
Puberty
Puberty, Precocious*
Receptors, LHRH
Reference Values
Dopamine
Follicle Stimulating Hormone
Glutamine
Gonadotropin-Releasing Hormone
Methylphenidate
Neurotransmitter Agents
Norepinephrine
Prolactin
Receptors, LHRH