Polypharmacy in a nine year old boy with Attention Deficit Hyperactivity Disorder and Tourette Syndrome: what worsened the ties?
- Author:
Wan Salwina Wan Ismail
;
Aili Hanim Hashim
;
Manveen Kaur
;
Shell Pin Choo
;
Fairuz Nazri Abdul Rahman
- Publication Type:Journal Article
- Keywords:
Fluvoxamine;
Atomoxetine;
Worsening tics
- MeSH:
Attention Deficit Disorder with Hyperactivity
- From:Malaysian Journal of Medicine and Health Sciences
2014;10(2):79-81
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Attention Deficit Hyperactivity Disorder(ADHD) and Tourrete Syndrome(TS) commonly
co-occur, imposing a special challenge in the management. Case report: This is a case of a nine year old
boy with ADHD and TS, who had been on methylphenidate, risperidone, fluvoxamine and atomoxetine,
alone and in combination. Tics worsened with methylphenidate but improved after its withdrawal, and
the addition of risperidone and fluvoxamine. Later, atomoxetine was added which worsened the tics,
even when it was removed. Significant improvement in the tics were only obvious when fluvoxamine
was taken off. Discussion: The possible roles of dopamine and serotonin neurotransmission, and
metabolism of cytochrome P450 D26 in the pathophysiology were discussed. Conclusion: The use of
multiple medications need cautious consideration and monitoring in a child patient to avoid unwanted
complications and risks.
- Full text:P020150604543814822915.pdf
