First episode psychosis and the use of psychostimulants - a case report
Introduction Stimulants are considered the mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD), and most patients are put on a long-term regimen with these psychostimulants. However some children treated with psychostimulants have reported psychosis as an adverse effect. Ob...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821020447/type/journal_article |
| _version_ | 1797616352754663424 |
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| author | T. Teixeira S. Martins V. Carvalho |
| author_facet | T. Teixeira S. Martins V. Carvalho |
| author_sort | T. Teixeira |
| collection | DOAJ |
| description |
Introduction
Stimulants are considered the mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD), and most patients are put on a long-term regimen with these psychostimulants. However some children treated with psychostimulants have reported psychosis as an adverse effect.
Objectives
Understand the capacity of psychostimulant medications to induce psychotic symptoms and determine the frequency of such reactions in adolescents and young adults.
Methods
Non-systematic review of the literature in English, through research in PubMed. Additionally, a clinical case is exposed, which was treated at the psychiatric inpatient unit of the Tamega e Sousa hospital center.
Results
Some patients, including some with no identifiable risk factors, can develop drugrelated signs or symptoms of psychosis or mania, such as hallucinations, at usual doses of frequently used ADHD drugs. Age of onset of psychosis can be significantly earlier in individuals with a history of stimulant use. In our clinical case, a young man of 18 years, previously diagnosed with ADHD, was medicated with atomoxetine two months prior being admitted to our psychiatric unit. There was no reported history of a similar psychiatric condition, and no risk factors were identified. At admission, he had bizarre behavior, with allucinatory activity and delusions of persecution. Atomoxetine was suspended and started oral antipsychotic, with improvement of symptoms and stabilization of the clinical condition.
Conclusions
In adolescents and young adults with ADHD undergoing stimulant therapy, any psychotic symptoms or mood changes need to be carefully assessed at regular intervals by the physicians and the caregivers, in order to observe change in the symptoms.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:39:47Z |
| format | Article |
| id | doaj.art-22083b977c6542258c8eb863259fd8b2 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:39:47Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-22083b977c6542258c8eb863259fd8b22023-11-17T05:08:49ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S772S77310.1192/j.eurpsy.2021.2044First episode psychosis and the use of psychostimulants - a case reportT. Teixeira0S. Martins1V. Carvalho2Departamento De Psiquiatria E Saúde Mental, Centro Hospitalar Tâmega e Sousa, Penafiel, PortugalDepartamento De Psiquiatria E Saúde Mental, Centro Hospitalar Tâmega e Sousa, Penafiel, PortugalDepartamento De Psiquiatria E Saúde Mental, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal Introduction Stimulants are considered the mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD), and most patients are put on a long-term regimen with these psychostimulants. However some children treated with psychostimulants have reported psychosis as an adverse effect. Objectives Understand the capacity of psychostimulant medications to induce psychotic symptoms and determine the frequency of such reactions in adolescents and young adults. Methods Non-systematic review of the literature in English, through research in PubMed. Additionally, a clinical case is exposed, which was treated at the psychiatric inpatient unit of the Tamega e Sousa hospital center. Results Some patients, including some with no identifiable risk factors, can develop drugrelated signs or symptoms of psychosis or mania, such as hallucinations, at usual doses of frequently used ADHD drugs. Age of onset of psychosis can be significantly earlier in individuals with a history of stimulant use. In our clinical case, a young man of 18 years, previously diagnosed with ADHD, was medicated with atomoxetine two months prior being admitted to our psychiatric unit. There was no reported history of a similar psychiatric condition, and no risk factors were identified. At admission, he had bizarre behavior, with allucinatory activity and delusions of persecution. Atomoxetine was suspended and started oral antipsychotic, with improvement of symptoms and stabilization of the clinical condition. Conclusions In adolescents and young adults with ADHD undergoing stimulant therapy, any psychotic symptoms or mood changes need to be carefully assessed at regular intervals by the physicians and the caregivers, in order to observe change in the symptoms. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821020447/type/journal_articleFirst episode psychosisattention deficit hyperactivity disorderstimulants |
| spellingShingle | T. Teixeira S. Martins V. Carvalho First episode psychosis and the use of psychostimulants - a case report European Psychiatry First episode psychosis attention deficit hyperactivity disorder stimulants |
| title | First episode psychosis and the use of psychostimulants - a case report |
| title_full | First episode psychosis and the use of psychostimulants - a case report |
| title_fullStr | First episode psychosis and the use of psychostimulants - a case report |
| title_full_unstemmed | First episode psychosis and the use of psychostimulants - a case report |
| title_short | First episode psychosis and the use of psychostimulants - a case report |
| title_sort | first episode psychosis and the use of psychostimulants a case report |
| topic | First episode psychosis attention deficit hyperactivity disorder stimulants |
| url | https://www.cambridge.org/core/product/identifier/S0924933821020447/type/journal_article |
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