Unanticipated Pathological Laughter Following Atomoxetine Administration in a Child With Autism Spectrum Disorder and...

Area of Science:

• Neuroscience
• Psychiatry
• Pediatrics

Background:

• Atomoxetine, a selective norepinephrine reuptake inhibitor (NRI), is a common treatment for attention-deficit/hyperactivity disorder (ADHD).
• Atomoxetine has demonstrated efficacy in managing symptoms of autism spectrum disorder (ASD).
• While mood disturbances are known side effects, pathological laughter has not been previously documented.

Observation:

• A 6-year-old boy with ASD and ADHD experienced sudden, uncontrollable pathological laughter after initiating low-dose atomoxetine.
• Laughter episodes occurred spontaneously without emotional triggers and resolved within 10 days.
• Improvements in attention and eye contact were noted during the observation period.

Findings:

• Pathological laughter emerged as a potential, transient side effect of atomoxetine, even at low dosages.
• The episodes resolved despite continued atomoxetine, with a concurrent minor increase in risperidone dosage.
• No recurrence of pathological laughter was observed after atomoxetine dosage was increased.

Implications:

• Clinicians should monitor for rare mood-related side effects like pathological laughter in children with neurodevelopmental disorders on atomoxetine.
• The case highlights the importance of considering catecholamine influence on mood regulation in this population.
• Further research is warranted to understand the mechanisms and risk factors for atomoxetine-induced pathological laughter.