Hanım Hülya ALINAY, Hasan ŞEKER
Klinik Psikiyatri Dergisi - 2026;29(2):146-150
Methylphenidate is the first-line pharmacological agent used in the treatment of children with Autism Spectrum Disorder (ASD) and comorbid Attention-Deficit Hyperactivity Disorder (ADHD); however, it may rarely cause movement disorders. This case report presents a 9-year-old male patient who developed acute orofacial and limb dyskinesia following the initiation of high-dose modified-release methylphenidate, four weeks after the abrupt discontinuation of aripiprazole treatment. The dyskinesia completely regressed upon cessation of the stimulant therapy and did not recur during subsequent gradual dose titration. The case is discussed in the context of the hypothesis that dopaminergic hypersensitivity resulting from antipsychotic withdrawal may lower the threshold for stimulant-induced dyskinesia. Furthermore, the importance of careful dose titration and close clinical monitoring when re-initiating stimulant therapy is emphasized, particularly in patients with neurodevelopmental disorders who have a history of recent antipsychotic discontinuation.
