Atypical antipsychotic overdose in the pediatric population

Risperidone is an atypical antipsychotic medication commonly used to treat psychotic illnesses in adults. It is being used with increasing frequency in children and adolescents, even though it has yet to be approved for use in this population by the Food and Drug Administration. There are few reports in the literature regarding its safety in those younger than 18 years of age. We present the case of a 15-year-old who ingested 110 mg of risperidone in a suicide attempt and developed only transient lethargy, hypotension, and tachycardia without any other significant effects. We review the literature regarding risperidone overdose in all age groups and review the current literature regarding pediatric overdose with the other atypical antipsychotics currently available in the United States. From those cases it seems that special care may be warranted with all pediatric cases of atypical antipsychotic overdose, including monitoring in a high-intensity clinical setting to manage potential respiratory or cardiac difficulties.