Nefise Busra CELEBI, Mujdat ERARKADAS, Nursu CAKIN MEMIK
Klinik Psikiyatri Dergisi - 2026;29(2):151-156
Attention deficit hyperactivity disorder (ADHD) is a well-established risk factor for suicidal ideation, suicide attempts, and completed suicide. Methylphenidate, a first-line pharmacological treatment for ADHD, is being increasingly prescribed. Given the rising rates of methylphenidate use and the high prevalence of suicide among individuals with ADHD, it is anticipated that clinicians will increasingly encounter suicide attempts involving this easily accessible medication. However, there are limited case reports of suicide attempts involving methylphenidate in individuals with ADHD. In this case report, we present a comprehensive biopsychosocial evaluation of a 14-year-old adolescent girl with ADHD who attempted suicide by taking 900 mg of long-acting methylphenidate, while discussing potential underlying mechanisms and risk factors for suicidality. We also addressed the clinical management of high-dose methylphenidate ingestion in children and adolescents, a topic for which the literature provides limited guidance. This case highlights several risk factors for suicidal behavior in adolescents, including untreated ADHD, comorbid psychiatric disorder, dysfunctional family dynamics, emotional dysregulation, impulsivity, social stressors, academic difficulties, family history of suicide and inadequate coping mechanisms. Our findings emphasize the importance of sustained ADHD treatment, routine suicidality screening in adolescents with ADHD and providing psychoeducation for families. Suicidal behavior is a complex and multifactorial process shaped by the interaction of biological, psychological, and environmental factors. A multidisciplinary approach grounded in the biopsychosocial model is essential for effective assessment and intervention.
