Switch to Atomoxetine Treatment in a Patient Allergic to Methylphenidate

對Methylphenidate產生過敏反應的病人轉換以Atomoxetine治療

張清棊(Chin-Chi Chang) ； 賴德仁(Te-Jen Lai) ； 陳錦宏(Chin-Hung Chen)

《台灣精神醫學》 23卷1期 (2009/03) Pp. 80-85

https://doi.org/10.29478/TJP.200903.0009

摘要

目的：報告一位個案在使用methylphenidate之後產生皮膚過敏，而轉換至使用atomoxetine的過程。病例報告：一位被診斷為注意力不全疾患的十歲男孩，使用Methylphenidate每日15毫克治療，但很快發生過敏反應。個案皮膚出現搔癢感，並且在腿上發現水泡。在停止methylphenidate使用之後，過敏反應消失。病人治療藥物改為atomoxetine並繼續治療。在換藥後，個案對治療有顯著反應，治療過程中也沒有嚴重的副作用。結論：這份個案報告指出，當遇到病人對methylphenidate產生過敏反應時，可以考慮改換為atomoxetine繼續治療。

關鍵字

注意力不全過動疾患 ； atomoxetine ； methylphenidate ； 過敏

並列摘要

Objective: To report the case of a patient with an allergic reaction to methylphenidate, and the effect of drug shifting to atomoxetine. Case report: A 10-yearold boy was diagnosed with attention-deficit/hyperactivity disorder (ADHD) and had been treated with 15 mg of methylphenidate per day, but he presented an allergic reaction soon thereafter. An itching sensation on his body and several vesicles on his left leg were found. After discontinuation of methylphenidate, the skin allergy subsided. It was suggested that he take atomoxetine to replace methylphenidate. He had an excellent clinical response to the shift in medication, and had no intolerable side effects with atomoxetine. Conclusion: This single case report indicates that atomoxetine may be suggested for patients with ADHD when they have an intolerable allergic reaction to methylphenidate.

並列關鍵字

ADHD ； atomoxetine ； methylphenidate ； allergy

參考文獻

Pliszka S(2007).Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder.J Am Acad Child Adolesc Psychiatry.46,894-921.

Carrey NJ,Wiggins DM,Milin RP(1996).Pharmacological treatment of psychiatric disorders in children and adolescents: focus on guidelines for the primary care practitioner.Drugs.51,750-759.

Confino-Cohen R.,A. Goldberg(2005).Successful desensitizatiort of methyiphenidate-induced rash.J Child Adolesc Psychopharmacol.15,703-705.

Adkinson NF,Middleton E(eds.),Reed CE(eds.),Ellis EF(eds.)(1998).Allergy Principles and Practice.Mosby:St. Louis (Ml).

Gait SS(2008).Psychometric properties of the Chinese version of the Swanson, Nolan, and Pelham, version IV scale-parent form.Int J Methods Psychiatr Res.17,35-44.