ABSTRACT
Choreiform movements have been reported with stimulant medications, especially in adults. There is only limited evidence on the management of such reactions in children with attention deficit hyperactivity disorder. Hereby, we present the exacerbation of chorea with long-acting methylphenidate use in a 6-year-old child with acute rheumatic fever which resolved with switching to atomoxetine.
ABSTRACT
Raynaud's phenomenon is a recurrent vasospastic condition with reducing in peripheral blood flow due to cold, or emotional stress. White, blue and red discolorations occur during the attacks. Serotonin reuptake inhibitors, psychostimulants, and aripiprazole are reported to be related with Raynaud's phenomenon. Risperidone is an atypical antipsychotic drug with dopaminergic and serotonergic effects. In children and adolescents, risperidone is used for bipolar disorder, tic disorders, conduct disorder, schizophrenia, symptoms of irritability and self-mutilation. Here we report a case of Raynaud's phenomenon associated with risperidone in a 12-year-old boy. Raynaud's phenomenon occurred two weeks after starting risperidone and disappeared after stopping risperidone.
Subject(s)
Adolescent , Child , Humans , Male , Aripiprazole , Bipolar Disorder , Conduct Disorder , Risperidone , Schizophrenia , Selective Serotonin Reuptake Inhibitors , Stress, Psychological , Tic DisordersABSTRACT
Galactorrhea, as an adverse effect of psychotropic medications, usually develops due to high dose of antipsychotics. Selective serotonin reuptake inhibitors (SSRIs) have also been reported to be related to galactorrhea. To the best of our knowledge, no previous study reported galactorrhea with methylphenidate (MPH) use. Hereby, we report a case of an adolescent girl who developed galactorrhea after increasing his modifed-release oral MPH to 50 mg/day while under treatment of sertraline and very low dose haloperidol.
Subject(s)
Adolescent , Female , Humans , Pregnancy , Antipsychotic Agents , Galactorrhea , Haloperidol , Methylphenidate , Selective Serotonin Reuptake Inhibitors , SertralineABSTRACT
Pisa syndrome, a rare dystonic reaction resulting from prolonged exposure to antipsychotic medications, is characterized by persistent dystonia of trunk muscles and abnormal posture. It is called Pisa syndrome, because the abnormal posture resembles the Leaning Tower of Pisa. Different from other types of dystonic reactions, Pisa syndrome is more prevalent in females and in older patients with organic brain changes. A 15-year-old male patient with mental retardation was admitted to pediatric neurology clinic for the complaint of abnormal posturing. He had been taking only risperidone for the last four years. Over the last month, the patient gradually developed tonic flexion of trunk and head toward left and was diagnosed with Pisa syndrome. In this paper, we aimed to discuss the association between risperidone use and Pisa syndrome in light of the available literature.
Subject(s)
Adolescent , Child , Female , Humans , Male , Brain , Dystonia , Head , Intellectual Disability , Muscles , Neurology , Posture , RisperidoneABSTRACT
Almost one-fifth of children who sustain a traumatic brain injury (TBI) are under the risk of attention problems after injury. The efficacy and tolerability of methylphenidate (MPH) in children with a history of TBI have not been completely identified. In this case report, MPH-induced manic symptoms in an adolescent with TBI will be summarized. A male patient aged 17 years was admitted with the complaints of attention difficulties on schoolwork and forgetfullness which became evident after TBI. Long-acting MPH was administered with the dose of 18 mg/day for attention problems. After one week, patient presented with the complaints of talking to himself, delusional thoughts, irritability and sleeplessness. This case highlights the fact that therapeutic dose of MPH may cause mania-like symptoms in children with TBI. Close monitarization and slow dose titration are crucial when considering MPH in children with TBI.
Subject(s)
Adolescent , Child , Humans , Male , Bipolar Disorder , Brain Injuries , Delusions , Methylphenidate , Sleep Initiation and Maintenance DisordersABSTRACT
The purpose of this study was to determine the impact of mean platelet volume [MPV] on the frequency and severity of vaso-occlusive and cerebrovascular events in patients with sickle cell anemia [SCA]. The 238 cases diagnosed with SCA were evaluated retrospectively with respect to the occurrence of painful crisis for the previous year. The incidence, severity and type of the vaso-occlusive crises of the patients with SCA between March 2010 and March 2011 were recorded. The last MPV values in patients who were free of erythrocyte transfusion for the last three months and who had no current vaso-occlusive crises were evaluated. All the patients were grouped according to the frequency of the crises for the previous year preceding the data collection. Group 1: 1 to 3 crises, Group 2: 4 to 5 and Group 3: 6 or more crises annually. In accordance with the results obtained during the evaluation of the cases diagnosed with sickle-cell anemia, MPV value was found to be significantly higher in patients with cerebrovascular events. Also MPV values increased with increasing incidence of the crises [r=0.297] [p=0.001]. One of the contributing factors for this clinical heterogeneity may be related to the MPV values in patients with sickle cell anemia. The higher MPV values may be an early predictor of future cerebrovascular events in patients with sickle cell anemia and may require close follow-up and additional measures