American Board of Psychiatry and Neurology (ABPN) Practice Exam

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What is the best choice for treating ADHD in a patient with Tourette's syndrome?

  1. Bupropion

  2. Methylphenidate

  3. Dextroamphetamine

  4. Atomoxetine

The correct answer is: Atomoxetine

The best choice for treating ADHD in a patient with Tourette's syndrome is atomoxetine. This medication is a non-stimulant and is considered safer for individuals with Tourette's because stimulant medications, like methylphenidate and dextroamphetamine, have been associated with increased tics or exacerbation of Tourette's symptoms in some patients. Atomoxetine, a selective norepinephrine reuptake inhibitor, has shown efficacy in treating ADHD without the risk of worsening tic disorders. It can help manage the symptoms of ADHD effectively while minimizing the potential negative impact on Tourette's, making it a well-suited option for this patient population. In contrast, while bupropion is also a non-stimulant, it is generally not the first-line treatment for ADHD and may carry its own risks related to seizure threshold, particularly in patients with certain neurological conditions. Choosing atomoxetine in this context aligns with best practices for managing ADHD in patients who also have Tourette’s syndrome.