A Report of Three Cases With Dissociative Disorder: Some Positive Response to Methylphenidate Extended Release Used for Their Concurrent Attention Deficit Hyperactivity Disorder

Although no psychotropic medication is specifically effective for dissociative symptoms, certain abusive substances can markedly alter these symptoms. Regarding psychotropic medications, a positive response was observed in certain patients with dissociative symptoms who also have attention deficit hyperactivity disorder (ADHD), for which methylphenidate extended release (MER) was administered. A is a female in her twenties and has dissociative identity disorder (DID) and ADHD. Primary personality A1 is usually on duty but always on guard, as her other personality, A2, often attempts to disturb A1. A1's job is also hampered by careless mistakes due to her ADHD. After A was put on MER, A1 felt that A2's presence suddenly faded away while on duty and she could focus better on her job as a result. B is a middle-aged male with DID and ADHD whose life is disturbed by the occasional appearance of a violent and disruptive personality. When MER was administered for his ADHD symptoms, it helped him stay alert, and his violent episodes decreased significantly. C is a young male university student with occasional dissociative "foggy" episodes that leave him with amnesia. He is diagnosed with depersonalization-derealization disorder (DDD) and ADHD. After MER was administered for his ADHD symptoms, his dissociative episodes diminished markedly, and his job performance improved significantly as a result. When MER is administered for patients with dissociative conditions and comorbid ADHD, it appears to have positive effects on their dissociative symptoms, including increasing the threshold separating different personalities or diminishing depersonalization symptoms.