Effect of Biperiden Treatment in Acute Orofacial and Extremity Dyskinesia With Methylphenidate Therapy.
Methylphenidate is a stimulant drug commonly prescribed to individuals with attention-deficit/hyperactivity disorder. The suggested underlying mechanism of acute dyskinesias is dopaminergic transmission increase. We describe a 9-year-old boy with a diagnosis of attention-deficit/hyperactivity disorder admitted to emergency clinic with primarily orofacial and extremity dyskinesia after administration of a first dose of 18 mg OROS (osmotic [controlled] release oral) methylphenidate (Concerta). OROS methylphenidate was discontinued, and the patient's symptoms resolved within 20 minutes after injection of biperiden by intravenous route (0.04 mg/kg). We wish to emphasize that acute orofacial dyskinesia and extremity dyskinesia can be observed during methylphenidate therapy and that biperiden can be successfully used in the treatment of this unpleasant condition. To the best of our knowledge, this is the first report of the use of biperiden therapy in this condition. This case report highlights the importance for physicians of awareness of dyskinesia as a potential adverse effect of methylphenidate therapy and indicates benefit of biperiden therapy.
From the Departments of Pediatric Neurology and.
Elif Acar
EA
Arslan
Neurosurgery, Karadeniz Technical University School of Medicine, Trabzon.
Erhan
E
Arslan
Emergency Clinic, Kent Hospital.
Anil
A
Kilinç
Clinic of Psychology, Giresun Prof Dr Ilhan Ozdemir Hospital, Giresun, Turkey.
Özkan
Ö
Göksu
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D001712:Biperiden / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D020820:Dyskinesias / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects* / Q000627:therapeutic use; D010276:Parasympatholytics / Q000627:therapeutic use*
D000697:Central Nervous System Stimulants; D010276:Parasympatholytics; D001712:Biperiden; D008774:Methylphenidate