ABSTRACT
In children and adolescents with intellectual disabilities, both physical and psychiatric comorbidity rates are higher than in developmentally normal children and attention deficit hyperactivity disorder and conduct disorder are among the most common psychiatric conditions. Treatment of children with intellectual disability is similar to the treatment of attention deficit hyperactivity disorder (ADHD) with developmentally normal children, but in various cases, different treatment options such as alpha-2 agonists are needed. In this report, we present an adolescent boy with intellectual disability and comorbid attention deficit hyperactivity disorder, conduct disorder, who was unresponsive to methylphenidate and atomoxetine but significantly benefited from clonidine treatment in ADHD symptoms and associated behavioral problems.
Keywords:
Clonidine, intellectual disability, attention deficit hyperactivity disorder, conduct disorder
References
1
Durukan İ. Zeka Geriliği (Zihinsel Engellilik). Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları. Akay AP, Ercan ES, Perçinel İ, Ardıç ÜA, Güney SA, Demirkaya SK, Güler AS, Yazıcı KU, eds. Ankara: Türkiye Çocuk ve Genç Psikiyatrisi Derneği Yayınları 2016;114-125.
2
Şengül ŞS. Zeka geriliği olan çocuklarda tamamlayıcı ve alternatif tedavi uygulamaları. Anadolu Psikiyatri Derg. 2009;10:24-5.
3
Volkmar FR, Dykens E. Mental Retardation. In: Levis M, eds. Köroğlu E, (çev). Child and adolescent psychiatry. Philadelphia: Lippincott Williams and Wilkins. 2003;603-611.
4
Biederman J, Spencer TJ, Wilens TE, Prince JB, Faraone SV. Commentary: Treatment of ADHD with stimulant medications: Response to Nissen perspective in The New England Journal of Medicine. J Am Acad Child Adolesc Pyschiatry. 2006;45:1147-1150.
5
Aman MG, Buican B, Arnold LE. Methylphenidate treatment in children with borderline IQ and mental retardation: Analysis of three aggregated studies. J Child Adolesc Psychopharmacol. 2003;13:29-40.
6
Simonoff E, Taylor E, Baird G, Bernard S, Chadwick O, Liang H, Whitwell S, Riemer K, Sharma K, Sharma SP, Wood N, Kelly J, Golaszewski A, Kennedy J, Rodney L, West N, Walwyn R, Jichi F. Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability. J Child Psychol Psychiatry. 2013;54:527-535.
7
Fernández-Jaén A, Fernández-Mayoralas DM, Pérez BC, Muñoz - Jareño N, Campos-Diáz M. Atomoxetine for attention deficit hyperactivity disorder in menta retardation. Pediatric Neurology. 2010;43:341-347.
8
Wilens TE, Kratochvil C, Newcorn JH, Gao H. Do children and adolescents with ADHD respond differently to atomoxetine?. Journal of theAmerican Academy of Child &Adolescent Psychiatry. 2006;45:149-157.
9
Karadağ M, Gökçen C. Mental Retardasyonu Olan Çocuk ve Ergenlerin Tedavisinde Kullanılan Farmakolojik Ajanlar. Çocuk ve Gençlik Ruh Sağlığı Dergisi. 2017;24:271-282.
10
Connor DF, Barkley RA, Davis HT. A pilot study of methylphenidate, clonidine, or the combination in ADHD comorbid with aggressive oppositional defiant or conduct disorder. Clin Pediatr. 2000;39:15-25.
11
Hazell PL & Stuart JE. A randomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. J Am Acad. 2000;42:886-894.
12
Connor DF, Findling RL, Kollins SH, Sallee F, López FA, Lyne A, Tremblay G. Effects of guanfacine extended release on oppositional symptoms in children aged 6-12 years with attention-defici thyper- activity disorder and oppositional symptoms: a randomized, double-blind, placebo-controlled trial. Cent Nerv Syst Drugs. 2010;24:755-768.
13
Mao ZM, Li BM, Arnsten AF. Roles of adrenoreceptor in prefrontal cortical cognitive functions. Sheng Li Ke Xue Jin Zhan. 1999;30:17-22.
14
Sibley MH, Kuriyan AB, Evans SW, Waxmonsky JG, Smith BH. Pharmacological and psychosocial treatments for adolescents with ADHD: an updated systematic review of thel iterature. Clin Psychol Rev. 2014;34:218-232.
15
Wilens TE, Bukstein O, Brams M, Cutler AJ, Childress A, Rugino T, Lyne A, Grannis K, Youcha S. A controlled trial of extended-release guanfacine and psychostimulants for attention-deficit/hyperactivitydisorder. J Am Acad Child Adolesc Psychiatry. 2012;51:74-85.
