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Drug induced mania in a boy with high functioning autism
Mustafa Deniz Tutkunkardas1, Nahit Motavalli Mukaddes
1Child, and Adolescent Psychiatry Department, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
Psychopharmacology Bulletin
|November 6, 2010
Summary
Drug-induced mania can occur with medications not intended for the central nervous system. This case highlights potential triggers like dexamethasone, cyclophosphamide, and cotrimoxazole in an adolescent leukemia patient with autism.
Area of Science:
- Oncology
- Neuropsychiatry
- Pharmacology
Background:
- Drug-induced mania is a recognized phenomenon, occasionally linked to medications not primarily targeting the central nervous system.
- Corticosteroids, chemotherapy agents, and antibiotics are among the drug classes with reported associations with mood disturbances.
Observation:
- A case report details a manic episode in an adolescent diagnosed with high-functioning autism undergoing leukemia treatment.
- The patient was treated with multiple agents, including dexamethasone, cyclophosphamide, and cotrimoxazole.
Findings:
- Dexamethasone, a corticosteroid used for T-cell acute lymphoblastic leukemia (T-ALL), is a potential candidate for inducing mania.
- Cyclophosphamide and cotrimoxazole are also considered possible contributing factors, though less frequently cited in literature for mood disorders compared to corticosteroids.
- Establishing a definitive causal link between a specific drug and the manic episode remains challenging due to polypharmacy.
Implications:
- This case underscores the importance of considering non-neurologic medications as potential causes of psychiatric symptoms, particularly mania, in vulnerable patient populations.
- Further research is warranted to elucidate the specific mechanisms and relative contributions of various drugs, including corticosteroids and chemotherapy agents, in precipitating mood disorders.
- Clinicians should maintain a high index of suspicion for drug-induced mania in patients with leukemia and comorbid conditions like autism spectrum disorder, especially when initiating or altering treatment regimens.
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