Manic Symptoms Due to Methylphenidate Use in an Adolescent with Traumatic Brain Injury

Abstract

Almost one-fifth of children who sustain a traumatic brain injury (TBI) are under the risk of attention problems after injury. The efficacy and tolerability of methylphenidate (MPH) in children with a history of TBI have not been completely identified. In this case report, MPH-induced manic symptoms in an adolescent with TBI will be summarized. A male patient aged 17 years was admitted with the complaints of attention difficulties on schoolwork and forgetfullness which became evident after TBI. Long-acting MPH was administered with the dose of 18 mg/day for attention problems. After one week, patient presented with the complaints of talking to himself, delusional thoughts, irritability and sleeplessness. This case highlights the fact that therapeutic dose of MPH may cause mania-like symptoms in children with TBI. Close monitarization and slow dose titration are crucial when considering MPH in children with TBI.

Manic Symptoms Due to Modified-Release Methylphenidate Use: An Adolescent Case

“…Premorbid ADHD, ID, and the use of high doses have been proposed to be risk factors. 4 Our case had ID along with ADHD, which could have predisposed him to develop this adverse effect. Many studies have suggested the efficacy of MPH for treatment of ADHD symptoms in children with ID.…”

“…Increased dopaminergic and/or noradrenergic activity in these regions may be related with the emergence of the symptoms. 4 Eventually, this case highlights the fact that therapeutic dose of modified-release MPH may cause mania-like symptoms in children and adolescents with ID, the symptoms may not resolve after discontinuation of MPH, and psychopharmacological interventions may require to control these symptoms.…”

The antimanic-like effects of andrographolide and quercetin

“…Methylphenidate, which blocks dopamine reuptake, was shown to induce hyperlocomotion, which was prevented by lithium, valproate carbamazepine, and antipsychotic drug administration (Nogoceke et al, 2016;Souza et al, 2016;Tonelli et al, 2013;Barbosa et al, 2011;. Moreover, methylphenidate can induce manic-like symptoms in humans (Ekinci et al, 2016;Chakraborty and Grover, 2011;Huey et al, 1981;Smith and Davis, 1977).…”