Risperidone overdose causes extrapyramidal effects but not cardiac toxicity

Journal of Clinical Psychopharmacology
Colin B PageGeoffrey K Isbister

Abstract

The aim of this study was to describe the clinical and electrocardiographic features of risperidone overdose, including the frequency of dystonic reactions. A consecutive series of admissions for risperidone overdose (>6 mg) were identified from a prospective database of poisoning admissions to a regional toxicology service. Data extracted included patient demographics, details of ingestion, clinical features including neurological findings and evidence of dystonias, electrocardiographic parameters (heart rate [HR], QRS, and QT intervals), complications, and medical outcomes including intensive care unit admission. In addition to descriptive statistics, visual inspection of plots of QT-HR pairs compared with the QT nomogram was performed. There were 107 patients with 157 presentations, including 38 patients with 45 risperidone-alone overdoses. Of the 38 patients who ingested risperidone alone, the median age was 25 years (interquartile range [IQR],16-31 years), and 19 (50%) were female. The median dose ingested was 33 mg (IQR, 15-75 mg; range, 8-248 mg). Median length of stay was 16 hours (IQR, 8-18 hours), and none was ventilated or admitted to the intensive care unit. There were 5 cases (11%) with dystonic reactions, 26 (58%)...Continue Reading

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Citations

Dec 29, 2013·European Journal of Pediatrics·Marianne MeliAlessandro Ceschi
Mar 4, 2014·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·M E TsayB Anderson
May 5, 2012·The Journal of Emergency Medicine·Alicia B Minns, Richard F Clark
Nov 22, 2012·British Journal of Clinical Pharmacology·Geoffrey K Isbister, Colin B Page
Sep 17, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Ingrid Berling, Geoffrey K Isbister
Feb 3, 2015·Annals of Emergency Medicine·Ingrid Berling, Geoffrey K Isbister
Mar 8, 2016·British Journal of Clinical Pharmacology·Ingrid BerlingGeoffrey K Isbister
Nov 20, 2018·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Thierry VialBehrouz Kassai
Jan 26, 2021·Drug Development and Industrial Pharmacy·George BebawyOssama Y Abdallaha

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