Atomoxetine Induced Skin Picking: A Case Report

Abstract

“Skin picking disorder,” also known as “dermatillomania” or “psychogenic excoriation,” is classified in the “Obsessive Compulsive and Related Disorders” category in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and characterized by repetitive skin picking behaviors resulting in skin lesions. Atomoxetine (ATX) is a selective norepinephrine (noradrenaline) reuptake inhibitor commonly used in the management of attention-deficit/hyperactivity disorder. Atomoxetine is considered to increase levels of noradrenaline and dopamine by inhibiting norepinephrine transporters. In this case report, we present an 8-year-old male attention-deficit/hyperactivity disorder patient with skin picking behavior due to ATX treatment. We discussed possible explanations of skin picking behavior with ATX in the light of the current literature. To our knowledge, this is the first report of skin picking due to ATX in literature, and further studies are needed to investigate the frequency and mechanisms of skin picking with ATX.

Norepinephrine and dopamine contribute to distinct repetitive behaviors induced by novel odorant stress in male and female mice

“…The Sapap3-/-model of OCD, which also displays excessive grooming behavior and hyperactivity of the PFC, is associated with abnormalities in DA receptor expression in the CTSC loop (Ahmari et al, 2013;Manning et al, 2019;Manning et al, 2021). Plausibly, persistent excitation of PFC neurons by stress-induced catecholamine release may be a causal mechanism for increased repetitive behavior in patients with compulsive disorders and in animal models featuring excessive grooming as part of their phenotypes (Kasar and Yurteri, 2020;Leckman et al, 1995;McGrath et al, 1999;Zhang et al, 2013).…”

Norepinephrine and dopamine contribute to distinct repetitive behaviors induced by novel odorant stress in male and female mice

“…The Sapap3−/− model of OCD, which also displays excessive grooming behavior and hyperactivity of the PFC, is associated with abnormalities in DA receptor expression in the CTSC loop (Ahmari et al, 2013; Manning et al, 2019; Manning et al, 2021). Plausibly, persistent excitation of PFC neurons by stress-induced catecholamine release may be a causal mechanism for increased repetitive behavior in patients with compulsive disorders and in animal models featuring excessive grooming as part of their phenotypes (Kasar and Yurteri, 2020; Leckman et al, 1995; McGrath et al, 1999; Zhang et al, 2013).…”

The Role of Age and Gender in Developing Body-Focused Repetitive Behavior Disorders among Adolescents

“…This taboo encourages a lack of reporting and attempts to conceal the disease, and patients frequently seek therapy from a skin specialist instead of or in addition to a mental health professional. (Kasar & Yurteri, 2020;Ravindran et al, 2009).…”