Acute dyskinesia on starting methylphenidate after risperidone withdrawal

Abstract

We report on acute and transient dyskinesia occurring within hours of taking modified-release methylphenidate (Concerta XL) in a stimulant-naïve 7-year-old boy who had recently stopped taking risperidone. We propose that the mechanism of this adverse drug reaction is likely to be an interaction between supersensitive dopamine receptors and acute exposure to an indirect dopamine agonist. Clinicians need to be aware of this potential side effect, and to use the combination of psychostimulants and neuroleptic drugs with caution.