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Stimulant induced Dermatological and Vascular Complications in patients with ADHD: A literature review

Published online by Cambridge University Press:  01 September 2022

F. Arain ,
M. Jawad ,
A. Azeem ,
H. Arain ,
A. Williams  and
M. Zeshan
F. Arain*
Affiliation:
BronxCare Health System Icahn School of Medicine at Mount Sinai, Child & Adolescent Psychiatry, Bronx, United States of America
M. Jawad
Affiliation:
King Edward Medical University, Department Of Psychiatry, Lahore, Pakistan
A. Azeem
Affiliation:
American School of Doha, Psychiatry, Doha, Qatar
H. Arain
Affiliation:
Columbia University, Medicine, NY, United States of America
A. Williams
Affiliation:
Touro University California, Psychiatry, California, United States of America
M. Zeshan
Affiliation:
Rutgers New Jersey Medical School, Newark, Psychiatry, NJ, United States of America
*
*Corresponding author.

Abstract

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Introduction

Methylphenidate and amphetamine are the two most widely used stimulants in managing Attention Deficit Hyperactivity Disorder (ADHD)1. Reynaud’s phenomenon (RP) is a reversible distal vasoconstriction presenting with various dermatological symptoms. RP can secondarily develop after certain medications as well2.

Objectives

The review was undertaken to synthesize the incidence of RP within ADHD population treated with stimulants, and any causal relation of RP and stimulant-use.

Methods

PubMed, Psych-Info and Google Scholar were searched using these keywords: skin change, Raynaud, stimulants and methylphenidate. All relevant study types were included. Results were synthesized narratively.

Results

Initial search yielded 240 articles with 5 articles fulfilling our inclusion criteria. One was retrospective case-controlled study while remaining 4 were case reports. Six cases were identified with an age of 12-19 years, who presented with RP after being treated with methylphenidate-or-dextroamphetamine. In one case, multiple clinical signs of RP were seen with cold distal fingers, transient color changes and even frank ulceration3–6. In two cases, it was seen that RP was dose-dependent with stimulant use and got resolved after decreasing the dosage respectively. In case-control study, 32 cases with RP and 32 controls were enrolled. The results showed a statistically significant association (χ2 =5, p=0.01) between RP and past-or-current stimulant usage.7

Conclusions

The literature review suggests weak evidence of the association between RP and stimulant use but no evidence of any causal link. Further studies are needed to identify characters that can predict this adverse effect in vulnerable ADHD individuals.

Disclosure

No significant relationships.

Keywords

stimulantsvascular complicationsADHDReyanaud’s phenomenon
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S420
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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