A commentary on “A young man with acute dilated cardiomyopathy associated with methylphenidate”

With reference to the report by Nymark and colleagues,¹ there are some points that should be highlighted. There is certainly a debate over whether methylphenidate is truly safe regarding possible cardiac side effects. However, the patient had taken quetiapine for 17 months. The association of cardiomyopathy and methylphenidate was highlighted while, as the authors mention, quetiapine may be related to cardiomyopathy. The 18-year-old boy with attention-deficit hyperactivity disorder (ADHD) had taken quetiapine 900 mg/day for the long period of 17 months while he was suffering from ADHD and overweight. It is clear that the authors visited the patient for the first time in their hospital while he had cardiogenic shock, oilguria, and raised liver enzymes.

There is limited research available on quetiapine. One of the side effects of these types of antipsychotics is metabolic syndrome that might increase cardiovascular events. So, in addition to the possible association of cardiomyopathy and methylphenidate, the adverse events of antipsychotics such as weight gain and metabolic syndrome should be carefully considered, especially in children and adolescents.^2,3