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Related Concept Videos

Toxidromes: Clinical Features01:30

Toxidromes: Clinical Features

Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...
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Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
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Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Updated: Jun 10, 2026

Self-Administration of Drugs in Mouse Models of Feeding and Obesity
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Risperidone overdose causes extrapyramidal effects but not cardiac toxicity.

Colin B Page1, Leonie A Calver, Geoffrey K Isbister

  • 1Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia. cpage@bigpond.net.au

Journal of Clinical Psychopharmacology
|July 16, 2010
PubMed
Summary

Risperidone overdose typically causes mild effects, with tachycardia and dystonic reactions being the most common symptoms. Serious cardiac or neurological issues are rare in these cases.

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Area of Science:

  • Toxicology
  • Clinical Pharmacology
  • Emergency Medicine

Background:

  • Risperidone is an atypical antipsychotic used to treat schizophrenia and bipolar disorder.
  • Overdose can lead to various clinical manifestations, necessitating a clear understanding of its toxicity profile.
  • Dystonic reactions are a known adverse effect of antipsychotics, and their frequency in overdose requires investigation.

Purpose of the Study:

  • To characterize the clinical and electrocardiographic (ECG) features of risperidone overdose.
  • To determine the incidence of dystonic reactions following excessive risperidone ingestion.
  • To assess the severity of cardiac and neurological effects in risperidone overdose cases.

Main Methods:

  • Retrospective analysis of a prospective database of poisoning admissions.
  • Inclusion criteria: patients with risperidone overdose (>6 mg).
  • Data collected: demographics, ingestion details, clinical findings (neurological, dystonias), ECG parameters (HR, QRS, QT), complications, and outcomes. QT-HR pairs were visually inspected against a nomogram.

Main Results:

  • 107 patients with 157 presentations, including 38 patients with 45 risperidone-alone overdoses.
  • Median ingested dose: 33 mg. Median length of stay: 16 hours. No ICU admissions or ventilation.
  • Tachycardia (58%) and dystonic reactions (11%) were observed. No hypotension, seizures, or deaths. ECGs showed no acute dysrhythmias; 10% had abnormal QT-HR pairs, mostly with HR >110 bpm. Median QRS width was 80 ms.

Conclusions:

  • Risperidone overdose, when taken alone, generally results in minimal clinical effects.
  • Tachycardia and dystonic reactions are the primary manifestations of risperidone toxicity in overdose.
  • Severe cardiac abnormalities and significant neurological deficits appear to be uncommon following risperidone overdose.