Back to Browse Journals » Pharmacogenomics and Personalized Medicine » Volume 6

Importance of pharmacogenetics in the treatment of children with attention deficit hyperactive disorder: a case report

Authors Tan-kam T, Suthisisang C, Pavasuthipaisit C, Limsila P, Puangpetch A, Sukasem C

Received 6 August 2012

Accepted for publication 4 October 2012

Published 11 January 2013 Volume 2013:6 Pages 3—7


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Teerarat Tan-kam,1 Chutamanee Suthisisang,2 Chosita Pavasuthipaisit,1 Penkhae Limsila,1 Apichaya Puangpetch,3 Chonlaphat Sukasem3

1Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, 2Department of Pharmacology, Faculty of Pharmacy, Mahidol University, 3Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Abstract: This case report highlights the importance of pharmacogenetic testing in the treatment of attention deficit hyperactive disorder (ADHD). A 6-year-old boy diagnosed with ADHD was prescribed methylphenidate 5 mg twice daily (7 am and noon) and the family was compliant with administration of this medication. On the first day of treatment, the patient had an adverse reaction, becoming disobedient, more mischievous, erratic, resistant to discipline, would not go to sleep until midnight, and had a poor appetite. The All-In-One PGX (All-In-One Pharmacogenetics for Antipsychotics test for CYP2D6, CYP2C19, and CYP2C9) was performed using microarray-based and real-time polymerase chain reaction techniques. The genotype of our patient was identified to be CYP2D6*2/*10, with isoforms of the enzyme consistent with a predicted cytochrome P450 2D6 intermediate metabolizer phenotype. Consequently, the physician adjusted the methylphenidate dose to 2.5 mg once daily in the morning. At this dosage, the patient had a good response without any further adverse reactions. Pharmacogenetic testing should be included in the management plan for ADHD. In this case, cooperation between the medical team and the patients' relatives was key to successful treatment.

Keywords: attention deficit hyperactive disorder, pharmacogenomics, CYP2D6, adverse drug reactions, dose adjustment, intermediate metabolizer

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

CYP2C19 polymorphisms in the Thai population and the clinical response to clopidogrel in patients with atherothrombotic-risk factors

Sukasem C, Tunthong R, Chamnanphon M, Santon S, Jantararoungtong T, Koomdee N, Prommas S, Puangpetch A, Vathesatogkit P

Pharmacogenomics and Personalized Medicine 2013, 6:85-91

Published Date: 22 August 2013

Association of CYP2D6 and CYP2C19 polymorphisms and disease-free survival of Thai post-menopausal breast cancer patients who received adjuvant tamoxifen

Chamnanphon M, Pechatanan K, Sirachainan E, Trachu N, Chantratita W, Pasomsub E, Noonpakdee W, Sensorn I, Sukasem C

Pharmacogenomics and Personalized Medicine 2013, 6:37-48

Published Date: 24 May 2013

CYP2D6 polymorphisms influence the efficacy of adjuvant tamoxifen in Thai breast cancer patients

Sirachainan E, Jaruhathai S, Trachu N, Panvichian R, Sirisinha T, Ativitavas T, Ratanatharathorn V, Chamnanphon M, Sukasem C

Pharmacogenomics and Personalized Medicine 2012, 5:149-153

Published Date: 17 October 2012

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

True story about HIV: theory of viral sequestration and reserve infection

Barasa S

HIV/AIDS - Research and Palliative Care 2011, 3:125-133

Published Date: 8 December 2011

Particle size reduction to the nanometer range: a promising approach to improve buccal absorption of poorly water-soluble drugs

Rao S, Song Y, Peddie F, Evans AM

International Journal of Nanomedicine 2011, 6:1245-1251

Published Date: 20 June 2011

Current and developing therapeutic agents in the treatment of Chagas disease

Werner Apt

Drug Design, Development and Therapy 2010, 4:243-253

Published Date: 17 September 2010

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010