Concluded Case

Addiction

He has habits of frequently to taken smells of the petroleum products...10year old boy with ADHD. Chief Complaints Tics and irritable with hyperactive ,poor sleep. History No convulsions, normal delivery in hospital,no fever. Vitals Normal Physical Examination Good Investigations Not yet Diagnosis ADHD with tics.

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Concluded answer

Development history needed to rule out other aspects of Mental retardation and any pervasive developmental disorder features. If its purely ADHD, its his sensation seeking that might get him into these habits. Must rule out if there is any harmful or dependence pattern. Then plan contingency management and parent management training. I would ve started him on clonidine till maximum tolerable dosage for hyperkinetic behaviour and tics and also targeting some level of restlessness and anxiety. If he has Cognitive capacity, he can be amenable for HRT after his Attention issues are stabilized. Plan atomoxetine if needed.

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Development history needed to rule out other aspects of Mental retardation and any pervasive developmental disorder features. If its purely ADHD, its his sensation seeking that might get him into these habits. Must rule out if there is any harmful or dependence pattern. Then plan contingency management and parent management training. I would ve started him on clonidine till maximum tolerable dosage for hyperkinetic behaviour and tics and also targeting some level of restlessness and anxiety. If he has Cognitive capacity, he can be amenable for HRT after his Attention issues are stabilized. Plan atomoxetine if needed.

Thank you doctor
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Must be treated by well qualified clinical. Treat carefully nicely..psychologists .must be associated with studies 0problem .

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