A ‘bad’ boy’s behavior problems
Two weeks after changing medications, a hyperactive 11-year-old becomes manic and attempts suicide. Is the new regimen or an undiagnosed mental disorder to blame?
One year later, Mark takes no medications. He is behaving well at school and made the honor roll this fall. His teacher reports that Mark is “smart, well liked, but talks excessively,” though she says his talking is “not as out of control” as it was a year ago.
Mark recently began playing soccer as an outlet for his hyperactivity. He has not been penalized on the soccer field but is occasionally “over the edge,” pushing and shoving other players. When frustrated at home he has short outbursts, slams doors, and yells at his brother without being physically aggressive.
Mark’s office visits are infrequent, but he recently asked his mother to take him to his psychiatrist and counselor. His mother realizes he may soon need medication, but she wants to wait.
Related resources
- U.S. Food and Drug Administration. List of drugs receiving a boxed warning, other product labeling changes, and a medication guide pertaining to pediatric suicidality. www.fda.gov/cder/drug/antidepressants/MDD_alldruglist.pdf.
- Eli Lilly and Co. Questions and answers about the Strattera (atomoxetine) label change: a guide for patients and parents. www.strattera.com/1_5_news/Q&A_Strattera_label_update.pdf.
- U.S. Food and Drug Administration. Public health advisory: Suicidal thinking in children and adolescents being treated with Strattera (atomoxetine).www.fda.gov/cder/drug/advisory/atomoxetine.htm.
- Mann JJ, Apter A, Bertolote J, et al. Suicide prevention strategies: a systematic review. JAMA 2005;294(16):2064-74.
Drug brand names
- Divalproex sodium • Depakote
- Mixed amphetamine salts • Adderall XR
- Atomoxetine • Strattera
Disclosure
The authors report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.
