Atomoksetin ile İlişkili Motor Tikler: Bir Olgu Sunumu

Motor Tics Associated with Atomoxetine: A Case Report Patients with attention deficit and hyperactivity disorder (ADHD) are at increased risk for Tourette’s Disorder and other tic disorders. The cornerstone treatment for ADHD include the psychostimulants, such as methylphenidate. It is known that, psychostimulant use can increase existing tics or cause new tics. The selective norepinephrine reuptake inhibitor, atomoxetine, has been proposed to be an alternative medication for patients with ADHD and a comorbid tic disorder. However, there are case studies in the literature describing onset or increase of tics following treatment with atomoxetine. In this report, we discuss a clinical case that developed motor tics during atomoxetine treatment .Dikkat Eksikliği ve Hiperaktivite Bozukluğu (DEHB) tanılı olgular Tourette Sendromu ve diğer tik bozuklukları için artmış riske sahiptirler. Metilfenidat gibi psikostimulanlar DEHB’nin tedavisinde temel tedaviyi teşkil etmektedir. Psikostimulan ilaçların var olan tiklerde artışa ya da yeni tik oluşumuna neden olabileceği bilinmektedir. Özgül bir norepinefrin geri alım inhibitörü olan atomoksetinin, DEHB ile birlikte tik bozukluğu olan olgularda alternatif bir tedavi seçeneği olabileceği ileri sürülmektedir. Ancak literatürde atomoksetin tedavisi ile birlikte yeni tik oluşumu olan yamevcut tiklerin sıklığında artış bulunan olgu sunumları mevcuttur. Bu yazıda atomoksetin tedavisi ile motor tik oluşumu gözlenen bir olgu tartışılmıştır. d

Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder

Objective Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. Method The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. Results When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001). Conclusion This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches