Introduction: Attention deficit hyperactivity disorder (ADHD) is a common disease in
childhood and adolescence. In about 60% of pediatric patients, the symptoms persist
into adulthood. Treatment guidelines for adult ADHD patients suggestmultimodal therapy
consisting of psychostimulants and psychotherapy.Many adult ADHD patients also suffer
frompsychiatric comorbidities, among others obsessive–compulsive disorder (OCD). The
treatment of the comorbidity of ADHD and OCD remains challenging as the literature is
sparse. Moreover, the impact of psychostimulants on obsessive–compulsive symptoms
is still unclear.
Case Presentation: Here, we report on a 33-year-old patient with an OCD who was
unable to achieve sufficient remission under long-term guideline-based treatment for
OCD. The re-examination of the psychological symptoms revealed the presence of adult
ADHD as a comorbid disorder. The patient has already been treated with paroxetine and
quetiapine for the OCD. Due to the newly established diagnosis of ADHD, extendedrelease
methylphenidate (ER MPH) was administered in addition to a serotonin reuptake
inhibitor. After a dose of 30mg ER MPH, the patient reported an improvement in both the
ADHD and the obsessive–compulsive symptoms. After discharge, the patient reduced
ER MPH without consultation with a physician due to subjectively described side effects.
The discontinuation of medication led to a renewed increase in ADHD and obsessive–
compulsive symptoms. The readjustment to ER MPH in combination with sertraline and
quetiapine thereafter led to a significant improvement in the compulsive symptoms again.
Conclusion: The present case shows that in ADHD and comorbid
obsessive–compulsive disorder, treatment with psychostimulants can improve the
obsessive–compulsive symptoms in addition to the ADHD-specific symptoms. To our
knowledge, this is only the second case report describing a treatment with ER MPH
for an adult patient with OCD and ADHD comorbidity in the literature. Further research,
especially randomized controlled trials, is needed to standardize treatment options.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84484 |
| Date | 31 March 2023 |
| Creators | Dogan-Sander, Ezgi, Strauß, Maria |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1664-0640, 649833 |
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