Vol. 2 No. 2 (2025): Vol2, Iss2, 2025
Case Reports

Methylphenidate-Induced Hypomania in an Adult with Undiagnosed Bipolar II Disorder and ADHD: A Case Report

Aashruthaa S
Saveetha Institute of Medical and Technical Sciences, Thandalam-602105, Kanchipuram, Tamil Nadu, India

Published 2025-03-31

Keywords

  • Methylphenidate; Attention-Deficit/Hyperactivity Disorder; Bipolar II Disorder; Hypomania

Abstract

Methylphenidate is a first-line pharmacological agent for attention-deficit/hyperactivity disorder (ADHD). While generally well-tolerated, it may precipitate hypomania or mania, especially in patients with underlying bipolar spectrum disorders. A 34-year-old man presented with features of hypomania, including elevated mood, reduced need for sleep, and impulsive behavior, after initiating methylphenidate for presumed adult ADHD. Subsequent psychiatric evaluation uncovered an undiagnosed history consistent with bipolar II disorder. Methylphenidate was discontinued and mood stabilized with lamotrigine and psychoeducation. This case highlights the potential for psychostimulants to induce mood episodes in individuals with latent bipolarity, underscoring the importance of comprehensive psychiatric evaluation prior to initiating stimulant therapy.