Decreased serum glucose levels after initiation of methylphenidate in a patient status post-cerebellar tumour resection: a potential interaction with glipizide

Pharmacological intervention with methylphenidate to address the neurobehavioural deficits associated with various neurological disorders has increased during the past decade. One potential effect of methylphenidate use is its possible influence on serum glucose. This case report illustrates a signi...

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Bibliographic Details
Published inClinical drug investigation Vol. 27; no. 10; pp. 719 - 725
Main Authors Gontkovsky, Samuel T, Nevels, Robert, McDonald, Nicholas B, Winkelmann, Michael H
Format Journal Article
LanguageEnglish
Published New Zealand Wolters Kluwer Health, Inc 01.01.2007
Subjects
Adult
Blood Glucose - drug effects
Central Nervous System Stimulants - pharmacology
Cerebellar Neoplasms - surgery
Cognition Disorders - drug therapy
Diabetes Mellitus, Type 2 - drug therapy
Drug Interactions
Drug Labeling
Female
Glipizide - pharmacology
Humans
Methylphenidate - pharmacology
Risk Management
Sulfonylurea Compounds - pharmacology
United States
United States Food and Drug Administration
United States
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Summary:Pharmacological intervention with methylphenidate to address the neurobehavioural deficits associated with various neurological disorders has increased during the past decade. One potential effect of methylphenidate use is its possible influence on serum glucose. This case report illustrates a significant post-intervention decrease in blood glucose levels subsequent to initiation of methylphenidate to address neurocognitive deficits, status post-acute cerebellar tumour resection, in a 38-year-old female with type 2 diabetes mellitus. A decrease of 26% in serum glucose values was seen from the pretreatment to the post-treatment phase (p = 0.003). Hypotheses concerning drug-drug interactions are offered to explain this unusual outcome. Although anecdotal, this finding has important implications for use of methylphenidate in the treatment of persons with diabetes and should be considered in light of the recent vote of the Drug Safety and Risk Management Advisory Committee of the US FDA urging 'black box' warnings on stimulant medications used to treat attention-deficit/hyperactivity disorder.
ISSN:1173-2563
1179-1918
DOI:10.2165/00044011-200727100-00007