Methylphenidate treatment effectiveness in pica wiht attention deficit hyperactivity disorder. a case report

Abstract

Objectives. PICA is an eating disorder and behavior in which there is an irresistible desire to lick or eat non-nutritive substances for a period, at least, a moth. Prevalence and pathogenesis are unknown. Sensitive, digestive nutritional psychological and psychiatric disorders have been implicated in its origin and maintenance. It is considered to be impulsivity as the cardinal symptom, which in childhood is associated with other psychiatric and neurological disorders such as ADHD. Those disorders have dopaminergic dysfunctions as etiopathogenic hypothesis. It is described a 6 years old girl case who has PICA compatible symptoms, within an ADHD context and treatment efficacy with methylphenidate.

Methods. Clinical assessment is performed after and before treatment with Clinical Interview and Diagnostic Instruments. Analytical study it is also requested with special interest in iron and/or zinc levels, whose deficiency could be possible in relation to PICA.

Results. Methylphenidate as psychopharmacological treatment is started with increasing doses up to 30 mg per day as a single dose after breakfast. A month later, it can be appreciated a significant improvement, in both ADHD nuclear symptoms and its general behavior, as also more appropriate control of abnormal intakes.

Conclusions. In our case methylphenidate treatment, as well as being useful in ADHD central symptoms management, provides benefits due to a better impulse control in the uncontrollable abnormal intakes.