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Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S138-9
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Poster Presentations
[PP-031] Ref. No: 155
Mirtazapine treatment for weight loss and insomnia associated with methylphenidate:
A chart review
Sabri Hergüner, Arzu Hergüner
Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry
E-mail: cocukergen@yahoo.com
Introduction: Stimulants are used as first-line treatment for children with attention deficit hyperactivity disorder (ADHD), and their safety
and efficacy are well established. Their most frequent adverse effects are sleep disturbance and decreased appetite which may limit
optimal dosing and compliance. The aim of this study was to investigate the efficacy of mirtazapine on OROS methylphenidate (MPH) -
induced weight loss and insomnia in children and adolescents with ADHD.
Methods: We reviewed the charts of children and adolescents diagnosed with ADHD and identified 18 individuals prescribed mirtazapine for weight
loss and/or insomnia while on OROS – MPH treatment. Of these, 2 discontinued mirtazapine within the first week due to excessive daytime sedation.
Results: Mirtazapine was well tolerated by the remaining 16 subjects and no other side effects were reported. All subjects gained weight
during concomitant mirtazapine treatment, with a mean gain of 2.1 kg. Fourteen of 16 children who had reported insomnia on MPH alone
noted significant improvements in sleep after initiation of mirtazapine.
Conclusion: In this chart review, mirtazapine was found to be beneficial for weight loss and insomnia associated with MPH treatment in
children and adolescents with ADHD.
Key words: Attention-deficit/hyperactivity disorder, children, methylphenidate, mirtazapine, insomnia, weight loss
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S139
[PP-032] Ref. No: 157
Rapid-onset hyponatremia induced by duloxetine in a middle-aged male with
depression and somatic symptoms
Jung Seok Choi, Hae Woo Lee, Jun Young Lee, Hee Yeon Jung
Department of psychiatry, Smg-Snu Boramae Medical Center, Seoul, Korea
E-mail: choijs@neuroimage.snu.ac.kr
Duloxetine is a relatively balanced selective serotonin and noradrenaline reuptake inhibitor. We report a case of hyponatremia induced by
duloxetine that developed rapidly after starting the medication in a middle-aged male with multiple somatic symptoms and depression.
Two days after discontinuation of duloxetine and management with hypertonic saline as well as fluid restriction, the serum sodium level
normalized. The patient had two risk factors for developing hyponatremia, namely severe weight loss and pneumonia. Therefore, when
treating patients with depression and somatic symptoms, especially with risk factors for developing hyponatremia, close monitoring for
clinical and laboratory evidence of hyponatremia may be essential.
Key words: Duloxetine, hyponatremia, middle-aged male, somatic symptoms, depression
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S139
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