{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:09:50Z","timestamp":1772168990176,"version":"3.50.1"},"reference-count":10,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2014,9,2]],"date-time":"2014-09-02T00:00:00Z","timestamp":1409616000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Methylphenidate is a commonly prescribed treatment for attention deficit hyperactivity disorder (ADHD). However, little is known about its adverse effects on the male reproductive system. We report a 20-year-old male patient whose chief complaint was of delayed puberty. He spoke in a high-pitched voice and complained of lack of body hair, impaired libido, inadequate erectile function, chronic fatigue, and low energy. He had been treated with methylphenidate as an infant and had continued treatment for 17 years. On examination, the patient was lean and visibly lacked facial or body hair. He further explained that he had never been able to grow underarm or facial hair and that he was often mistakenly considered a young teenager rather than a 20-year-old. The patient\u2019s genitalia were categorized as Tanner Stage 2. Laboratory studies confirmed low serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels. The patient was given exogenous testosterone supplementation with pellets and human chorionic gonadotropin to maintain testicular size. After 4 months his symptoms improved and he demonstrated signs of puberty. Our goal is to further elucidate the possible impact of methylphenidate on the male reproductive system.<\/ns4:p>","DOI":"10.12688\/f1000research.5163.1","type":"journal-article","created":{"date-parts":[[2014,9,2]],"date-time":"2014-09-02T11:10:04Z","timestamp":1409656204000},"page":"207","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Case Report: Testicular failure possibly associated with chronic use of methylphenidate"],"prefix":"10.12688","volume":"3","author":[{"given":"Ranjith","family":"Ramasamy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranav","family":"Dadhich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashna","family":"Dhingra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Lipshultz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2014,9,2]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867414538675","article-title":"Longitudinal trends in the dispensing of psychotropic medications in Australia from 2009\u20132012: Focus on children, adolescents and prescriber specialty.","author":"E Karanges","year":"2014","journal-title":"Aust N Z J Psychiatry."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"34-46.e2","DOI":"10.1016\/j.jaac.2013.09.001","article-title":"Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit\/hyperactivity disorder: United States, 2003\u20132011.","volume":"53","author":"S Visser","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"151-66","DOI":"10.1080\/10673220802167782","article-title":"ADHD and the rise in stimulant use among children.","volume":"16","author":"R Mayes","year":"2008","journal-title":"Harv Rev Psychiatry."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"16301-6","DOI":"10.1073\/pnas.1102187108","article-title":"Pubertal delay in male nonhuman primates (Macaca mulatta) treated with methylphenidate.","volume":"108","author":"D Mattison","year":"2011","journal-title":"Proc Natl Acad Sci U S A."},{"key":"ref-5","first-page":"232-6","article-title":"The effect of chronic administration of methylphenidate on morphometric parameters of testes and fertility in male mice.","volume":"13","author":"S Fazelipour","year":"2012","journal-title":"J Reprod Infertil."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"647-50","DOI":"10.1016\/j.juro.2012.09.043","article-title":"Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy.","volume":"189","author":"T Hsieh","year":"2013","journal-title":"J Urol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"122-9","DOI":"10.1016\/j.physbeh.2014.05.016","article-title":"Effects of repeated administration of methylphenidate on reproductive parameters in male rats.","volume":"133","author":"B Montagnini","year":"2014","journal-title":"Physiol Behav."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"1592-600","DOI":"10.1177\/0960327110394224","article-title":"Methylphenidate has dose-dependent negative effects on rat spermatogenesis: decreased round spermatids and testicular weight and increased p53 expression and apoptosis.","volume":"30","author":"A Cansu","year":"2011","journal-title":"Hum Exp Toxicol."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"478-81","DOI":"10.1097\/FBP.0b013e328364bfee","article-title":"Effects of chronic methylphenidate in adolescence on later methylphenidate self-administration in rhesus monkeys.","volume":"24","author":"S Martelle","year":"2013","journal-title":"Behav Pharmacol."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"29-32","DOI":"10.5694\/mja12.10931","article-title":"Growth and pubertal development of adolescent boys on stimulant medication for attention deficit hyperactivity disorder.","volume":"198","author":"A Poulton","year":"2013","journal-title":"Med J Aust."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/3-207\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/3-207\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/3-207\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T15:35:52Z","timestamp":1543937752000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/3-207\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,2]]},"references-count":10,"URL":"https:\/\/doi.org\/10.12688\/f1000research.5163.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.5507.r6010","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.5507.r6064","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.5507.r6011","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.5507.r6011","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.5507.r6064","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.5507.r6010","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,2]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/3-207\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.5507.r6010, Wayland Hsiao, Department of Urology, Emory University, Atlanta, GA, USA, 03 Sep 2014, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/3-207\/v1#referee-response-6010","order":0,"name":"referee-response-6010","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Ranjith Ramasamy<\/b>; \n<i>Posted: 03 Sep 2014<\/i>; We agree with the reviewer that the association between chronic ritalin use and testicular failure is not direct. The case report is at best hypothesis generating but given some of the strong evidences available in animal studies, the practitioner should be cognizant of a &quot;possible&quot; association between chronic ritalin use and infertility and delayed puberty.","URL":"https:\/\/f1000research.com\/articles\/3-207\/v1#referee-comment-958","order":1,"name":"referee-comment-958","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.5507.r6064, Matthew Coward, Department of Urology, University of North Carolina, Chapel Hill, NC, USA, 08 Sep 2014, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/3-207\/v1#referee-response-6064","order":2,"name":"referee-response-6064","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.5507.r6011, Jay Sandlow, Christopher Deibert, Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA, 11 Sep 2014, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/3-207\/v1#referee-response-6011","order":3,"name":"referee-response-6011","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"RR is an NIH K12 Scholar supported by a Male Reproductive Health Research Career (MHRH) Development Physician-Scientist Award (HD073917-01) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Program.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}