1 Northwestern University Medical School, Chicago, Illinois 60611
The adverse reaction to a single 40-mg dose of methylphenidate in a 38-kg child reported by Sleator1 is unusual and resembles a response that I have observed in a milder form and reported previously in one child who received a daily dose of 40 mg administered in two equal divided amounts.2 This patient had difficulty in speaking and in moving his lips and tongue, associated with twitching movements of the face. Drug administration was continued in a lower dosage because hyperactivity was affected, and the untoward reactions were relieved.