Methylphenidate and Autism Ranking: Mildly Hazardous Strong positive evidence

Risks and Safety


According to NICE (2000)

“Common adverse effects of treatment include insomnia, nervousness, headache, decreased appetite, abdominal pain and other gastrointestinal symptoms, and cardiovascular effects such as tachycardia, palpitations and minor increases in blood pressure.”

According to the BNF website, accessed on 21 May 2018, side effects may include

“Uncommon: Abnormal dreams; confusion; constipation; dyspnoea; epistaxis; haematuria; muscle cramps; suicidal ideation; urinary frequency. Rare: Angina; sweating; visual disturbances. Very rare: Angle-closure glaucoma; blood disorders; cerebral arteritis; dependence; erythema multiforme; exfoliative dermatitis; hepatic dysfunction; leucopenia; myocardial infarction; neuroleptic malignant syndrome; psychosis; seizures; thrombocytopenia; tolerance; Tourette syndrome. Frequency not known: Bradycardia; convulsions; supraventricular tachycardia.”

The Royal College of Psychiatrists recommends that a child being treated with stimulants 'should have their height and weight measured regularly' because of possible effects on appetite.

Please see U.S. National Library of Medicine (2017) for a full list of other potential side effects.

- Individuals on the autism spectrum

Researchers have identified some potential hazards for individuals on the autism spectrum.  For example, Cortese et al (2012) reported

"The most common adverse events associated with the use of psychostimulants in children and adolescents with ASD include: appetite reduction, sleep-onset difficulties, irritability and emotional outbursts."


There are some contraindications (something which makes a particular treatment or procedure potentially inadvisable) for methylphenidate. For example, according to the BNF website, accessed on 21 May 2018, methylphenidate may be contraindicated in individuals with the following conditions: 

“Anorexia nervosa; arrhythmias; cardiomyopathy; cardiovascular disease; cerebrovascular disorders; heart failure; hyperthyroidism; phaeochromocytoma; psychosis; severe depression; severe hypertension; structural cardiac abnormalities; suicidal ideation; uncontrolled bipolar disorder; vasculitis.”


Angina (chest pain caused by reduced blood flow to the heart muscles); angle-closure glaucoma (damage to the optic nerve caused by pressure of the fluid inside the eye); anorexia nervosa (eating disorder); arrhythmias (irregular heartbeats); bipolar disorder ( condition that affects your moods, which can swing from one extreme to another); bradycardia (slow heart beat); cardiomyopathy (diseases of the heart muscle) ; cardiovascular disease(disease affecting the heart or blood vessels); cerebral arteritis (inflammation of the blood vessel wall affecting the brain); cerebrovascular disorders (diseases that affect the blood vessels of the brain and blood circulation); dyspnoea (difficult or laboured breathing); epistaxis (nosebleed); erythema multiforme (skin condition); exfoliative dermatitis (redness and peeling of the skin); haematuria (presence of blood in the urine); hepatic dysfunction (liver failure); hyperthyroidism (excessive production of thyroid hormone); leucopenia (reduction in the number of white cells in the blood); myocardial infarction (heart attack); neuroleptic malignant syndrome (life-threatening reaction to antipsychotics); phaeochromocytoma (rare tumour of adrenal gland tissue); psychosis (mental health problem in which a person's perception of reality becomes distorted); hypertension (high blood pressure); structural cardiac abnormalities (defect or abnormality of the heart that does not affect the blood vessels in the heart); suicidal ideation (suicidal thoughts); supraventricular tachycardia (abnormally fast heart beat);  thrombocytopenia (low blood platelet count); Tourette syndrome (condition characterised by a combination of involuntary noises and movements called tics); vasculitis (inflammation of the blood vessel wall).

24 Dec 2018
Last Review
01 Dec 2018
Next Review
01 Dec 2021