ADHD and disruptive mood dysregulation disorder treatment with olanzapine and methylphenidate: a case report

Attention deficit hyperactivity disorder (ADHD) is one of the most common disorders in childhood which deficits of inattention, hyperactivity and impulsive behavior. Disruptive Mood Dysregulation Disorder is characterized by severe recurrent temper outbursts that are inconsistent with developmental level and manifest verbally or behaviorally. The disorder can co-exist with ADHD and conduct disorder. In treatment of ADHD most commonly used pharmacological agent is methylphenidate. Atypical antipsychotics (e.g. risperidone, aripiprazole, olanzapine…) can be added on the treatment in some cases because of unsatisfactory clinical response and comorbidities such as conduct disorder, pervasive developmental disorders, disruptive mood dysregulation disorder, mental retardation. Olanzapine is one of the FDA-approved atypical antipsychotic, which antagonize the dopaminergic (D1, D2, D4), serotoninergic (5-HT2A, 5-HT2C, 5-HT6), histaminergic (H1), alpha1- adrenergic and muscarinic (especially M1) receptors. It is used increasingly for the treatment of mood disorders, schizophrenia, conduct disorder and pervasive developmental disorders at child and adolescent psychiatry clinics. Studies pointed out that it caused mostly dry mouth, weigh gain, increase appetite, sedation and hyperlipidemia. In this article, we report a 8-years-old male patient, who have ADHD, disruptive mood dysregulation disorder and conduct disorder, treated with olanzapine and OROS methylphenidate. This issue deserves to get attention that these two psychopharmacologic agents were usable concominantly for ADHD and its comorbidities.