Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder
BackgroundIt is known that patients reporting chronic pain often experience trauma or post-traumatic stress disorder (PTSD) and tend to be more difficult to treat. Attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, is frequently associated with chronic pain. Furthermore,...
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| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1221694/full |
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| author | Satoshi Kasahara Satoshi Kasahara Miwako Takahashi Taito Morita Ko Matsudaira Naoko Sato Toshimitsu Momose Shin-Ichi Niwa Kanji Uchida |
| author_facet | Satoshi Kasahara Satoshi Kasahara Miwako Takahashi Taito Morita Ko Matsudaira Naoko Sato Toshimitsu Momose Shin-Ichi Niwa Kanji Uchida |
| author_sort | Satoshi Kasahara |
| collection | DOAJ |
| description | BackgroundIt is known that patients reporting chronic pain often experience trauma or post-traumatic stress disorder (PTSD) and tend to be more difficult to treat. Attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, is frequently associated with chronic pain. Furthermore, patients diagnosed with ADHD are more likely to encounter trauma and develop PTSD because of their inattentive and impulsive tendencies. There are reports stating that atomoxetine (ATX), a selective noradrenaline reuptake inhibitor for ADHD, is effective in patients diagnosed with PTSD and ADHD. However, there have been no reports on cases of comorbid PTSD and ADHD with chronic pain, and ATX’s potential in improving chronic pain coexisting PTSD. Furthermore, no reports have evaluated patient cerebral blood flow in conjunction with the course of treatment with ATX for chronic pain.Case reportIn this study, we reported a case where ATX improved chronic pain with PTSD and improved cerebral blood flow. The patient was a 56-year-old woman exhibiting chronic pain with PTSD, resulting from 6 years of severe domestic violence from her common-law husband. She had no history of ADHD diagnosis, but through aggressive screening, comorbid ADHD was diagnosed. When treated with ATX, there were significant improvements in her pain, quality of life, anxiety, depression, catastrophic thoughts, and cerebral blood flow. As a result, she could resume work after 11 years.ConclusionThe study showed that chronic pain with PTSD may be comorbid with ADHD. Moreover, we found that ATX can improve chronic pain with PTSD and cerebral blood flow. Aggressive screening of ADHD is important because once the diagnosis of comorbidity is confirmed, an ideal ADHD treatment can be selected. Therefore, based on the results of this study, ATX may be a candidate for treatment for cases of chronic pain with PTSD and ADHD. |
| first_indexed | 2024-03-12T17:00:22Z |
| format | Article |
| id | doaj.art-fdd9ee97cff44b719c1404c989e4c276 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-12T17:00:22Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-fdd9ee97cff44b719c1404c989e4c2762023-08-07T18:13:50ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-08-011410.3389/fpsyt.2023.12216941221694Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorderSatoshi Kasahara0Satoshi Kasahara1Miwako Takahashi2Taito Morita3Ko Matsudaira4Naoko Sato5Toshimitsu Momose6Shin-Ichi Niwa7Kanji Uchida8Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, JapanDepartment of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, JapanInstitute for Quantum Medical Science, National Institutes for Quantum Science and Technology (QST), Chiba, JapanDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, JapanDepartment of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, JapanNursing Department, The University of Tokyo Hospital, Tokyo, JapanInstitute of Engineering Innovation, School of Engineering, The University of Tokyo, Tokyo, JapanDepartment of Psychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, JapanBackgroundIt is known that patients reporting chronic pain often experience trauma or post-traumatic stress disorder (PTSD) and tend to be more difficult to treat. Attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, is frequently associated with chronic pain. Furthermore, patients diagnosed with ADHD are more likely to encounter trauma and develop PTSD because of their inattentive and impulsive tendencies. There are reports stating that atomoxetine (ATX), a selective noradrenaline reuptake inhibitor for ADHD, is effective in patients diagnosed with PTSD and ADHD. However, there have been no reports on cases of comorbid PTSD and ADHD with chronic pain, and ATX’s potential in improving chronic pain coexisting PTSD. Furthermore, no reports have evaluated patient cerebral blood flow in conjunction with the course of treatment with ATX for chronic pain.Case reportIn this study, we reported a case where ATX improved chronic pain with PTSD and improved cerebral blood flow. The patient was a 56-year-old woman exhibiting chronic pain with PTSD, resulting from 6 years of severe domestic violence from her common-law husband. She had no history of ADHD diagnosis, but through aggressive screening, comorbid ADHD was diagnosed. When treated with ATX, there were significant improvements in her pain, quality of life, anxiety, depression, catastrophic thoughts, and cerebral blood flow. As a result, she could resume work after 11 years.ConclusionThe study showed that chronic pain with PTSD may be comorbid with ADHD. Moreover, we found that ATX can improve chronic pain with PTSD and cerebral blood flow. Aggressive screening of ADHD is important because once the diagnosis of comorbidity is confirmed, an ideal ADHD treatment can be selected. Therefore, based on the results of this study, ATX may be a candidate for treatment for cases of chronic pain with PTSD and ADHD.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1221694/fullatomoxetineattention deficit hyperactivity disordercerebral blood flowchronic painpost-traumatic stress disordersingle-photon emission computed tomography |
| spellingShingle | Satoshi Kasahara Satoshi Kasahara Miwako Takahashi Taito Morita Ko Matsudaira Naoko Sato Toshimitsu Momose Shin-Ichi Niwa Kanji Uchida Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder Frontiers in Psychiatry atomoxetine attention deficit hyperactivity disorder cerebral blood flow chronic pain post-traumatic stress disorder single-photon emission computed tomography |
| title | Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder |
| title_full | Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder |
| title_fullStr | Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder |
| title_full_unstemmed | Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder |
| title_short | Case report: Atomoxetine improves chronic pain with comorbid post-traumatic stress disorder and attention deficit hyperactivity disorder |
| title_sort | case report atomoxetine improves chronic pain with comorbid post traumatic stress disorder and attention deficit hyperactivity disorder |
| topic | atomoxetine attention deficit hyperactivity disorder cerebral blood flow chronic pain post-traumatic stress disorder single-photon emission computed tomography |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1221694/full |
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