title: Severe avoidant/restrictive food intake disorder and coexisting stimulant treated attention deficit hyperactivity disorder.
abstract: There is a growing body of literature describing the development, clinical course, and treatment of avoidant/restrictive food intake disorder (ARFID), a diagnostic category introduced in the DSM-5. However, information surrounding complex cases of ARFID involving coexisting medical and/or psychiatric disorders remains scarce. Here we report on two cases of young patients diagnosed concurrently with ARFID and attention deficit hyperactivity disorder (ADHD) who both experienced significant growth restriction following initiation of stimulant medication. The appetite suppressant effect of stimulants exacerbated longstanding avoidant and restrictive eating behaviors resulting in growth restriction and admission to an inpatient eating disorders unit. The implications of ARFID exacerbated by stimulant-treated ADHD are explored, as well as the treatment delivered. These cases suggest that further research is needed to explore management options to counteract the appetite suppression effects of stimulants, while simultaneously addressing attention deficit symptoms and oppositional behavior. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1036-1039).
authors: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors: Alexandra
authors: A
authors: Pennell
authors: Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
authors: Jennifer
authors: J
authors: Couturier
authors: Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
authors: Christina
authors: C
authors: Grant
authors: Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
authors: Natasha
authors: N
authors: Johnson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D004435:Eating; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male
chemical_list: D000697:Central Nervous System Stimulants
keywords: adolescents; attention deficit hyperactivity disorder; avoidant restrictive intake disorder; eating disorder