Editing Methylphenidate (section)

=== Overdose ===
The symptoms of a moderate acute overdose of methylphenidate primarily arise from [[central nervous system]] overstimulation; these symptoms include: [[vomiting]], [[nausea]], [[psychomotor agitation|agitation]], [[tremor]]s, [[hyperreflexia]], muscle twitching, [[euphoria]], confusion, [[hallucination]]s, [[delirium]], [[hyperthermia]], sweating, [[flushing (physiology)|flushing]], headache, [[tachycardia]], [[heart palpitation]]s, [[cardiac arrhythmia]]s, [[hypertension]], [[mydriasis]], and dryness of [[mucous membrane]]s.<ref name="Daytrana FDA label" /><ref name="MPH INCHEM" /> A severe overdose may involve symptoms such as [[hyperpyrexia]], [[sympathomimetic toxidrome]], [[convulsion]]s, [[paranoia]], [[stereotypy]] (a repetitive movement disorder), [[rhabdomyolysis]], [[coma]], and [[circulatory collapse]].<ref name="Daytrana FDA label" /><ref name="MPH INCHEM">{{cite web |vauthors=Heedes G, Ailakis J |title=Methylphenidate hydrochloride (PIM 344) |url=http://www.inchem.org/documents/pims/pharm/pim344.htm |website=INCHEM |publisher=International Programme on Chemical Safety| access-date=23 June 2015 |archive-url=https://web.archive.org/web/20150623102325/http://www.inchem.org/documents/pims/pharm/pim344.htm |archive-date=23 June 2015 |url-status=live}}</ref><ref name="ADHD toxidrome">{{cite journal | vauthors = Spiller HA, Hays HL, Aleguas A | title = Overdose of drugs for attention-deficit hyperactivity disorder: Clinical presentation, mechanisms of toxicity, and management | journal = CNS Drugs | volume = 27 | issue = 7 | pages = 531–543 | date = July 2013 | pmid = 23757186 | doi = 10.1007/s40263-013-0084-8 | s2cid = 40931380 | doi-access = free }}</ref>{{efn|
The management of amphetamine, dextroamphetamine, and methylphenidate overdose is largely supportive, with a focus on interruption of the sympathomimetic syndrome with judicious use of benzodiazepines. In cases where agitation, delirium, and movement disorders are unresponsive to benzodiazepines, second-line therapies include antipsychotics such as ziprasidone or haloperidol, central alpha-adrenoreceptor agonists such as dexmedetomidine, or propofol. ... However, fatalities are rare with appropriate care.<ref name="ADHD toxidrome"/>
}}
A methylphenidate overdose is rarely fatal with appropriate care.<ref name="ADHD toxidrome" /> Following injection of methylphenidate tablets into an [[artery]], severe toxic reactions involving [[abscess]] formation and [[necrosis]] have been reported.<ref name="pmid21984207">{{cite journal | vauthors = Bruggisser M, Bodmer M, Liechti ME | title = Severe toxicity due to injected but not oral or nasal abuse of methylphenidate tablets | journal = [[Swiss Medical Weekly]] | volume = 141 | page = w13267 | year = 2011 | pmid = 21984207 | doi = 10.4414/smw.2011.13267 | doi-access = free }}</ref>

Treatment of a methylphenidate overdose typically involves the administration of [[benzodiazepine]]s, with [[antipsychotic]]s, [[α-adrenoceptor]] agonists and [[propofol]] serving as second-line therapies.<ref name="ADHD toxidrome" />

[[File:Add Wize Methylphenidate Warning.jpg|thumb|Packaging of a formulation of methylphenidate advises against crushing the tablets. It is placed under Schedule&nbsp;X of the Indian drug scheduling system. Schedule&nbsp;X medications typically hold abusable medications such as barbiturates or stimulants such as amphetamines.]]