Abstract
Background
Paliperidone is an atypical antipsychotic that is approved to treat schizophrenia
in patients 12 years of age and older. There are minimal data on the clinical effects
of exposure in the < 12-year-old age group.
Case Report
We report the case of a 7-year-old girl who was accidentally dosed with paliperidone
for 3 days. Her clinical course was notable for a dystonic reaction and profound sinus
tachycardia, with a heart rate peaking at 201 beats/min. The tachycardia persisted
for over 64 h after her last dose. The mechanism of tachycardia has not been elucidated
and is likely multifactorial, with alpha blockade and anticholinergic effects probably
contributing.
Why Should an Emergency Physician Be Aware of This?
Clinicians should be aware that paliperidone ingestion in children may result in delayed,
profound tachycardia and may require more prolonged observation times or admission
to the hospital.
Keywords
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References
- Toxicity and clinical outcomes of paliperidone exposures reported to U.S. Poison Centers.Clin Toxicol (Phila). 2014; 52: 207-213
- Invega (paliperidone) extended-release tablets [package insert]. Pharmaceuticals, Inc., Titusville, NJ2007 (revised 7/2017)
- Paliperidone overdose with delayed onset of toxicity.Ann Emerg Med. 2011; 58: 80-82
- Severe prolonged posture-evoked tachycardia after massive overdose of paliperidone.Clin Toxicol (Phila). 2016; 54: 535
- Effects of risperidone in overdose.Am J Emerg Med. 1998; 16: 498-501
Article info
Publication history
Published online: October 04, 2019
Accepted:
June 29,
2019
Received in revised form:
June 25,
2019
Received:
May 15,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
