SYMPOSIA

Poster Presentations
[PP-110] Ref. No: 98
Methlyphenidate induced thrombocytopenia in a pediatric patient with
ADHD and stuttering
Serdal Özdemir, Fatma Ayık Özdemir
İnönü Üniversitesi Tıp Fakültesi Turgut Özal Tıp Merkezi Psikiyatri AD, Malatya, Turkey
E-mail: serdoktor@yahoo.com
Stuttering and attention deficit hyperactivity disorder (ADHD) can be seen together. Anemia or thrombocytopenia, rarely even pancytopenia
may occur as a side effect of medications used to treat both disorders. Thrombocytopenia, although it may be seen in some cases using
methylphenidate, occurs rarely. An 8 year-old boy was brought to our outpatient clinic by his family with the complaints of stuttering, attention
deficit, and hyperactivity. After the psychiatric evaluation and history were conducted and psychometric tests were applied. One month later
methylphenidate 18mg/day was started for the treatment of ADHD. Soon after initiation of medication, petechia developed on both lower
extremities of the patient. CBC showed isolated thrombocytopenia and te patient was followed by hematology clinic. On the 6th day upon
stopping mehtlyphenidate, the thrombocyte count returned to normal. We also discussed possible mechanisms of thrombocytopenia.
Key words: Isolated thrombocytopenia, petechia, methylphenidate
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S190
[PP-111] Ref. No: 245
Use of mirtazapine and olanzapine in treatment of major depressive disorder with
psychotic features developed during pregnancy: A case report
Mustafa Güleç 1 , Yavuz Selvi 2 , Ünsal Aydınoğlu 1
1 Atatürk Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Erzurum, Turkey
2 Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Van, Turkey
E-mail: mustafagulec78@yahoo.com
Objctive: To contribute to the of treatment of major depressive disorder with psychotic features developing during pregnancy
Case: A 25 year-old, married, female patient was 13 weeks pregnant and diagnosed with major depressive disorder (MDD) with psychotic
features. She was a housewife with primary school degree and was admitted to inpatient unit. The obstetrician did not find any fetal
anomalies. The patient was put on mirtazapine and olanzapine, doses of which ranged between 15-30mg/day and 5-10 mg/day,
respectively during her two months hospitalization. In her follow up, 15 days after discharge, olanzapine dose was decreased to 5 mg/day,
but mirtazapine was continued at 30mg/day until delivery. To decrease neural tube defect risk folic acid 5mg/day was prescribed during
the treatment, as well. She gave birth to a live and healthy baby on the expected due date during her outpatient treatment.
The information regarding the safety of use of mirtazapine and olanzapine during pregnancy primarily rely on case reports. While
there were no fetal abnormalities in majority of cases regarding olanzapine use (1,2), there are some reports including hip dysplesia (3),
meningocele ve ankyloblepharon (4), atrioventricular channel defect and unilateral pes equinovarus (5). However, more cases and studies
are needed to explore, whether these cases were coincidental or due to teratogenic effects of olanzapine. Currently available publications
(6,7,8,9) report that major malformation risk in general population does not increase with the use of mirtazapine during pregnancy. The
reports from our country are parallel to the reports in the literature (10,11).
Results: Even in majority of cases no fetal abnormalities were reported regarding olanzapine use during pregnancy, large case series are
needed to have more evidence for stronger judgments. Also even mirtazapine does not look like a teratogenic agent, is should be used
with caution during pregnancy and babies that are exposed to mirtazapine should be followed closely.
Key words: Depression, pregnancy, safety, mirtazapine, olanzapine, teratogenicity
References:
1. Littrell KH, Johnson CG, Peabody CD, Hilligoss N. Antipsychotics during pregnancy. Am J Psychiatry 2000; 157(8):1342
2. Mendhekar DN, War L, Sharma JB, Jiloha RC. Olanzapine and pregnancy. Pharmacopsychiatry 2002; 35(3):122-123
3. Spyropoulou AC, Zervas IM, Soldatos CR. Hip dysplasia following a case of olanzapine exposed pregnancy: a questionable association. Arch Womens Ment Health
2006; 9(4):219-222
4. Arora M, Praharaj SK. Meningocele and ankyloblepharon following in utero exposure to olanzapine. Eur Psychiatr 2006; 21(5):345-356
S190 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org