IMIPRAMINE INDUCED ACUTE DYSTONIA IN A CHILD WITH ENURESIS NOCTURNA

Authors : Cüneyt Uysal, Yakup Albayrak

Pages : 0-0

View : 12 | Download : 0

Publication Date : 2013-05-01

Article Type : Research Paper

Abstract :It is well known that some drugs and neurodegenerative processes, such asParkinson’s disease, can cause extrapyramidal side effects insert ignore into journalissuearticles values(1);. Extrapyramidal symptoms insert ignore into journalissuearticles values(ES); may be drug-induced and due affect tolerance and compliance insert ignore into journalissuearticles values(2);. ES includes akathisia, parkinsonian symptoms insert ignore into journalissuearticles values(e.g. tremor, bradykinesia and muscle rigidity); and impaired involuntary movements insert ignore into journalissuearticles values(e.g. acute dystonia and tardive dyskinesia); insert ignore into journalissuearticles values(3);. Especially, antipsychotic drugs therapy insert ignore into journalissuearticles values(4);, antiemetics, and a variety of other drugs insert ignore into journalissuearticles values(5); can frequently cause severe occurrences and complications insert ignore into journalissuearticles values(4);. Some drugs induced ES are thought to causean imbalance of dopamine and acetylcholine in the nigrostriatal pathwayinsert ignore into journalissuearticles values(1);. Tricyclic antidepressants insert ignore into journalissuearticles values(TCAs);, such as amitriptyline, imipramine, desipramine, clomipramine and doxepine, may have antidopaminergic effectinsert ignore into journalissuearticles values(2);. However, antidepressant drugs are not directly acting as dopamine antagonistsinsert ignore into journalissuearticles values(6);, but some movement disorders symptoms are rarely described as a side effect of tricyclic antidepressantsinsert ignore into journalissuearticles values(2);. Enuresis nocturna is a multidisciplinary problem worked on by such many physicians as pediatricians, urologists and child and adolescent psychiatrists insert ignore into journalissuearticles values(7); can cause a significant psychosocial problem for children and their parents insert ignore into journalissuearticles values(8);, which is estimated at 3.8% to 25% insert ignore into journalissuearticles values(9);. That is, there are over 50 million children with enuresis around the world insert ignore into journalissuearticles values(10);. Theaetiology of this condition is not totally known. Medical therapies including imipramine, desmopressin and anticholinergics, behavioural therapy and enuretic alarm devices are proposed to manage this conditioninsert ignore into journalissuearticles values(8);. TCAs drugs are widely used in the process of managing this condition insert ignore into journalissuearticles values(11);, for instance, Imipramine can reduce wetting in some children and young people insert ignore into journalissuearticles values(12);.Unsal et al. Here we report a case of imipramine induced acute dystonia in an enuretic child. 8- year-old boy with severe torticollis was assessed in our outpatient clinic and. Beforehand, he had been diagnosed as enuresis nocturna by a child psychiatrist and was given imipramine 10 mg/day for treatment. After three days initiating imipramine 10 mg/day, he had severe muscular spasm on his neck. He had no psychiatric and neurological history. Physical examination, vital signs, serum chemistries, blood counts were within normal limits. He wasonly taking imipramine, and no other medication had been used during this three days. He was diagnosed with imipramine induced dystonia and biperiden 5 mg was administered intramusculary. After 45 minutes, it was seen that torticollis was resolved and he was referred to child psychiatry for the treatment of enuresis nocturna.
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