Methylphenidate therapy for aggression in a man with ring 22 chromosome. Report and literature review
A. Reeve, S. A. Shulman, A. W. Zimmerman and S. B. Cassidy
A 28-year-old mentally retarded man with ring 22 chromosome [r(22)] had
deterioration of mood and behavior, decreased speech, bradykinesia, and
decline of fine motor skills over a three-year period, which were further
exacerbated by treatment with phenothiazines. A trial of methylphenidate
hydrochloride resulted in rapid improvement of mood, behavior, and to a
small extent, motor function. This finding suggests that dopamine depletion
may play a role in the behavioral deterioration seen in this disorder. The
possibility that genes that control dopamine metabolism may be present on
chromosome 22 is raised. The phenotype of this patient is compared with the
25 reported cases of r(22).
