Psychotic and manic-like symptoms during stimulant treatment of attention deficit hyperactivity disorder.
Psychotic and manic-like symptoms during stimulant treatment of attention deficit hyperactivity disorder.
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注意力缺陷多动障碍兴奋剂治疗期间出现精神病和躁狂样症状。
DOI：
10.1176/ajp.2006.163.7.1149
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Ross,RandalG
中科院分区：
文献类型：
--
作者：
Ross,RandalG
一个6岁9个月的男孩被他的母亲带到一个儿童精神科医生的困难与持续的注意力，分心，粗心的错误，听力差，难以遵循指示，组织困难，经常错位的项目，并在日常活动中健忘。他没有冲动或多动行为、情绪症状或抽搐的病史。他是在一次不起眼的足月妊娠后出生的，母亲43岁，在怀孕期间没有使用酒精或药物。孩子在分娩失败后通过剖宫产分娩，产后过程正常。他的家族史没有情绪障碍、精神病、强迫症状或抽搐，几个月后，这些症状在家庭、学校和辅导环境中得到了证实。患者当时7岁4个月，开始使用哌甲酯，并显示出明显的剂量反应效应。然后开了哌甲酯的缓释制剂，剂量在2个月内逐渐增加到每天40 mg。在这个剂量下，患者有强烈的有益反应，唯一的副作用是轻度厌食。8个月后，在8岁3个月大的时候，在一次类似流感的疾病之后，他出现了新的症状，包括在没有人在场的情况下听到声音和看到“成年人”，渴望“从楼梯上摔下来”，高度焦虑，在学校流泪，不愿意离开母亲身边，以及易怒。
A boy 6 years 9 months of age was brought by his mother to a child psychiatrist for difficulties with sustained attention, distraction, careless errors, poor listening, difficulty following instructions, difficulty with organization, frequently misplaced items, and forgetfulness in daily activities. He had no history of impulsive or hyperactive behavior, mood symptoms, or tics. He had been born after an unremarkable full-term pregnancy to a 43-year-old mother who did not use alcohol or drugs during pregnancy. The child was delivered by cesarean section after failure to progress in labor and had a normal postnatal course. His family history was negative for mood disorders, psychosis, obsessive-compulsive symptoms, or tics.Several months later, the symptoms had been confirmed in the home, school, and tutoring environments. The patient, then 7 years 4 months of age, was started on methylphenidate, and he showed a clear dose-response effect. An extended-release formulation of methylphenidate was then prescribed, and the dose was gradually increased over a 2-month period to 40 mg per day. At this dose, the patient had a strongly beneficial response, and the only side effect noted was mild anorexia. Eight months later, at 8 years 3 months of age, after a flu-like illness, he developed new symptoms, which included complaints of hearing voices and seeing “adults” when no one was present, a desire to “throw himself down the stairs,” high levels of anxiety, tearfulness at school, an unwillingness to leave his mother’s side, and irritability.