A case of an 11-year-old girl diagnosed with OCD developing giggle incontinence following addition of aripiprazole to treatment

Giggle incontinence (GI) is characterized by involuntary and generally unpredictable release of urine during giggling or laughter. It has been suggested that GI may be a centrally mediated disorder and may share a common pathophysiology with narcolepsy and cataplexy. The fact that methylphenidate reduces some symptoms suggests that the condition may be a cataplexy. While alpha 1 and dopamine D2 antagonists exacerbate cataplexy, alpha 1 and dopamine D2 agonists produce a marked improvement. Aripiprazole, frequently used to augment treatment of obsessive compulsive disorder, may have exhibited an alpha 1 and D2 receptor antagonist effect and have caused GI. We describe a case of GI occurring following aripiprazole use in an 11-year-old female obsessive compulsive disorder patient resistant to treatment.