There have been rare reports of Tourette's syndrome. Toxic psychosis has been reported. Chronically abusive use can lead to marked tolerance and psychic dependence with varying degrees of abnormal behavior. Frank psychotic episodes can occur, especially with parenteral abuse. Careful supervision is required during drug withdrawal, since severe depression as well as the effects of chronic overactivity can be unmasked.
Treatment consists of appropriate supportive measures.
The patient must be protected against self-injury and against external stimuli that would aggravate overstimulation already present. If signs and symptoms are not too severe and the patient is conscious, gastric contents may be evacuated by induction of emesis or gastric lavage. In the presence of severe intoxication, use a carefully titrated dosage of a short- acting barbiturate before performing gastric lavage. Efficacy of peritoneal dialysis or extracorporeal hemodialysis for Methylphenidate HCl overdosage has not been established. Administer in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals.