Psychiatry and Clinical Psychopharmacology

Usage of atomoxetine for encopresis and attention deficit-hyperactivity disorder

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S200-S200
Read: 741 Published: 17 February 2021

Atomoxetine, an effective treatment alternative of attention deficit-hyperactivity disorder (ADHD), is a selective presynaptic norepinephrine reuptake inhibitor. Also atomoxetine is shown as one of the options in the treatment of nocturnal enuresis and encopresis . A case with encopresis and ADHD will be presented in terms of atomoxetine treatment. A 7-year-old boy was admitted to our outpatient clinic with complaints of restlessness, forgetfulness, getting bored quickly, academic failure in the school and soiling his underwear. In his psychiatric examination; he was conscious, oriented, his cooperation was şuent and understandable. He had concentration problems, hyperactivity and impulsivity. There was no hallucination and delusion. He also had encopresis occurring 5 to 6 times a week for 1 year. His intelligence level was within normal limits according to psychiatric examination and IQ testing. The diagnosis was compatible with ADHD combined type and encopresis with constipation and overşow incontinence according to DSM-V. There was no history of psychiatric treatment. First of all, for the treatment of encopresis, behavioral intervention was suggested, but he and his parents did not adapt the recommendations. Atomoxetine, 18 mg/day, was initiated; and the dose was titrated up to 40 mg/day. The patient was invited to medical examination monthly. In the first month of follow-up period, the symptoms of attention deficiency, impulsivity decreased and school achievement improved. Furthermore, encopresis was observed only three times in a month. At the end of fifth month, he tolerated the medication well, and there was no encopresis. Encopresis is described as the repeated passage of feces into inappropriate places. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition describes two subtypes as “with constipation and overşow incontinence” and “without constipation and overşow incontinence.” The relationship between encopresis and attention difficulties, disruptive behavior, academic failure was declared. Coexistence of encopresis and ADHD symptoms are observed frequently. In the previous study, the efficacy of imipramine was demonstrated on encopresis. In addition, uses of atomoxetine and methylphenidate treatments were shown in two children with encopresis and ADHD. In our case, we observed the effects of atomoxetine on encopresis and ADHD however in terms of this observation needs to be studied with further studies.

EISSN 2475-0581