Reactions 1680, p54 - 2 Dec 2017 Aripiprazole/methylphenidate interaction Hiccup: case report A 16-year-old boy developed hiccups during concomitant treatment with aripiprazole and methylphenidate [routes not stated]. The boy, who had a history of attention deficit and hyperactivity disorder (ADHD), received treatment with extended-release methylphenidate 54 mg/day for five years. Later, he was diagnosed with ADHD and conduct disorder, and started receiving aripiprazole 2.5mg/day at night, along with the methylphenidate 54 mg/day. Within 12 hours of receiving aripiprazole, he developed an episode of hiccups in the morning that lasted for 4 hours. The boy presented to the clinic with great concern for hiccups, and, as he was extremely disturbed, he was not convinced to use aripiprazole. However, due to aggravation of his behavioural problems, his mother gave him aripiprazole again for two weekend days while he had drug holidays for methylphenidate. There were no hiccups seen with only aripiprazole. The boy started receiving aripiprazole in weekdays again with methylphenidate, and the hiccups returned after 12 hours which lasted for an hour. As there were no hiccups with aripiprazole alone, he continued receiving aripiprazole 5 mg/day with no hiccups observed. The elimination of aripiprazole involves two cytochrome P450 enzymes (CYP2D6, CYP3A4) and methylphenidate, can lead to increased aripiprazole blood levels by blocking the metabolism of aripiprazole or by competing with aripiprazole for CYP2D6 metabolism. Therefore, aripiprazole can cause hiccup when interacted with methylphenidate. Author comment: "In conclusion, we concluded that concurrent use of methylphenidate and aripiprazole in this adolescent led to hiccups." "Evaluation with the Naranjo algorithm revealed a score of 7 (probably adverse drug reaction)." Kutuk MO, et al. Hiccup due to aripiprazole plus methylphenidate treatment in an adolescent with attention deficit and hyperactivity disorder and conduct disorder: A case report. Clinical Psychopharmacology and Neuroscience 15: 410-412, No. 4, 30 Nov 2017. Available from: URL: http://doi.org/10.9758/cpn.2017.15.4.410 - Turkey 803284885 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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