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.
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.
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Published online: October 04, 2019
Accepted: June 29, 2019
Received in revised form: June 25, 2019
Received: May 15, 2019
© 2019 Elsevier Inc. All rights reserved.