Treatment of cardiogenic shock and vasopressor dependency with intravenous methylphenidate (Ritalin)

Four patients are presented who had prolonged hypotension secondary to cardiogenic shock and who were dependent on vasopressor substances for maintenance of blood pressure. The intravenous administration of methylphenidate appeared to allow the withdrawal of vasopressors and the maintenance thereafter of a statisfactory blood pressure. The rapidity of action suggests that the drug works on a peripheral basis.