Pharmacopsychiatry 2012; 45(01): 37-39
DOI: 10.1055/s-0031-1287776
Letter
© Georg Thieme Verlag KG Stuttgart · New York

A Case of Selective Mutism in an 8-Year-Old Girl with Thalassaemia Major after Bone Marrow Transplantation

P. L. Plener
1  Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
,
S. A. Gatz
2  Department of Child and Adolescent Medicine, University of Ulm, Ulm, Germany
,
C. Schuetz
2  Department of Child and Adolescent Medicine, University of Ulm, Ulm, Germany
,
A. G. Ludolph
1  Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
,
M. Kölch
1  Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
› Author Affiliations
Further Information

Publication History

received 16 April 2011
revised 29 July 2011

accepted 01 August 2011

Publication Date:
11 October 2011 (online)

Abstract

Selective mutism is rare with a prevalence below 1% in the general population, but a higher prevalence in populations at risk (children with speech retardation, migration). Evidence for treatment strategies is hardly available. This case report provides information on the treatment of selective mutism in an 8-year-old girl with preexisting thalassaemia major. As medications she received penicillin prophylaxis (500000 IE/d) and deferasirox (Exjade; 20–25mg/kg/d), an iron chelator. The preexisting somatic disease and treatment complicated the treatment, as there are no data about pharmacological combination therapy. Psychotherapy in day treatment, supported by the use of the SSRI fluoxetine (10 mg), led to a decrease in the selective mutism score from 33 to 12 points, GAF improved by 21 points. Mean levels of fluoxetine plus norfluoxetine were 287.8 ng/ml without significant level fluctuations.