Paliperidone overdose with delayed onset of toxicity
Michael Levine1, Frank Lovecchio, Paul Tafoya
1Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix, AZ 85006, USA. michael.levine@bannerhealth.com
Annals of Emergency Medicine
|March 8, 2011
Summary
Paliperidone overdose can cause delayed and prolonged toxicity, even in adolescents. This case highlights the importance of monitoring patients after significant paliperidone ingestion.
Area of Science:
- Pharmacology
- Toxicology
- Psychiatry
Background:
- Paliperidone (9-hydroxy risperidone) is an atypical antipsychotic approved by the FDA.
- It is the primary active metabolite of risperidone but formulated as an extended-release product.
- Paliperidone differs from risperidone in its pharmacokinetic profile and formulation.
Observation:
- A 14-year-old female weighing 59 kg ingested 180 mg (3.1 mg/kg) of paliperidone.
- The patient had a history of psychosis and major depressive disorder.
- Toxicity symptoms presented with a delayed onset and extended duration.
Findings:
- This case represents one of the first documented instances of paliperidone overdose in the literature.
- The overdose resulted in significant toxicity, characterized by delayed onset and prolonged symptom duration.
- The extended-release formulation may influence the pharmacokinetic profile and toxicity presentation.
Implications:
- Clinicians should be aware of the potential for delayed and prolonged toxicity with paliperidone overdose.
- Extended monitoring may be necessary for patients experiencing significant paliperidone ingestions.
- Further research is needed to fully understand the toxicokinetics and management of paliperidone overdose, especially in adolescent populations.
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