Disulfiram/methylphenidate interaction
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Psychosis: case report A 31-year-old man experienced psychotic symptoms due to an interaction between disulfiram and methylphenidate. The man had attention-deficit hyperactivity disorder, and had undergone detoxification for alcohol, cocaine and nicotine dependence. He started treatment with methylphenidate at 36 mg/day for the first 2 weeks, and disulfiram 250 mg/day over 4 weeks [routes not stated]. He maintained abstinence from alcohol, cocaine and other stimulants during the treatment period, and was monitored via urine tests every 3 days. After the first two weeks, the methylphenidate dosage was increased to 54 mg/day. Psychotic symptoms were then observed, including auditory hallucinations, blockages of thought, delusional misconduct, delusions of injury, self-reference, and suspicion [time to reaction onset not stated]. The man was initiated on olanzapine, and displayed immediate clinical improvement. Methylphenidate was withdrawn, and disulfiram was discontinued shortly after. In 2 weeks, all his symptoms had completely resolved. Author comment: "We report the case of disulfiram and methylphenidate interaction in which psychotic symptoms could be dose dependent." Grau-Lopez L, et al. Psychosis induced by the interaction between disulfiram and methylphenidate may be dose dependent. Substance Abuse 33: 186-8, No. 2, 2012 803078605 - Spain
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Reactions 20 Oct 2012 No. 1424
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