SYMPOSIA

Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Abstracts of the Invited Speakers
with epilepsy have ADHD as well. Some antiepileptic drugs are known to cause lethargy and impairment of attention. Barbiturates and
benzodiazepines may worsen the symptoms of ADHD. It has been reported that some drugs such as tiagabin, zonisamide, and topiramate
can cause cognitive slowing and concentration problems. Psychostimulants are frequently used in the treatment of ADHD. It has been
reported that these medications do not severely effect epileptic seizures and may improve cognitive functions.
In this presentation treatment approaches for children and adolescents with ADHD and co-morbid neurological disorders will be
discussed.
Key words: ADHD, children, neurological co-morbidity, treatment
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S96-7
Drug interactions of medications for comorbidities of ADHD
Osman Abalı
İstanbul Medical Faculty, Child and Adolescent Psychiatry, İstanbul, Turkey
E-mail: osmanabal@hotmail.com
ADHD is a very common psychiatric disorder in childhood. Children with ADHD have frequently another psychiatric disorder. Conduct
disorder, learning disorder, addiction, and mood disorders are frequently seen in children with ADHD. It has been estimated that 23%-
42% of youth receiving psychiatric drugs are receiving multiple drugs (1). Recently drug interactions have been emphasized in these
patients. Stimulant drugs and atomoxetine, which is a non stimulant drug, are used in patients with ADHD. Interactions between these
drugs and other psychotropic drugs are important for treatment quality. Drug interactions should be considered to prevent adverse
effects and increase treatment quality. Possible drug interactions could impact on liver, intestine, or plasma. There are a lot of important
risks due to drug interactions in patients with ADHD. Drug plasma levels can change due to CYP-P450 system interactions. It is estimated
that approximately 7% of the population may be poor metabolizers, causing slow metabolism(2). Also inhibitors of the cytochrome P450
can increase drug levels by several folds. Some drugs inhibit these systems very potently so that concentration of drug can reach very
high levels. Important complications such as neuroleptic malignnant syndrome, serotonergic syndrome, and hallucinations can be seen
during these interactions. Treatment strategies should be reviewed from this perspective. Possible drug interactions couldn’t be exactly
predicted by the clinicians for every patient. But potential drug interactions should be considered for every patient. Drug interactions will
be discussed at this presentation. The treatment strategies will be updated for long term good quality treatment based on the literature.
Key words: ADHD, drug interactions, co-morbidity
References:
1. McIntyre RS, Jerrell JM. Polypharmacy in children and adolescents treated for major depressive disoerder: a claims database study. Journal of clinical
psychiatry.2009;70(2):24-46.
2. Barton J: Atomoxetin: a new pharmacotherapeutic approach in the managment of ADHD, Archives of disease in childhood 2005;1(90):26-29.
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S97
[PS-22]
Symposium Title: How to fight with bipolar disorder? From guidelines to clinical practice: Myths and realities
Treatment of mixed episodes of bipolar disorders in manuals. What are the recommendations?
Ahmet Ünal
Gaziantep University, Faculty of Medicine, Department of Psychiatry, Gaziantep, Turkey
E-mail: drahmetunal@hotmail.com
There are still clinical states with uncertainties in psychiatry in terms of diagnosis and treatment. Mixed states in bipolar disorders is one
of these states. The Diagnostic and Statistical Manual of Mental Disorders – IV (DSM – IV) defines mixed states as a period in which manic
and depressive diagnosis criteria prevail together. However, observing all depressive and manic symptoms together during the mixed
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