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Risperidone


Presentation

  • CONCLUSION: This study suggests that oral risperidone may be a safe option for acute agitation in patients presenting to the ED with alcohol intoxication. Copyright 2017 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
Trismus
  • Two months after switching from risperidone to paliperidone, his eye blinking, light sensitivity, jaw pain, and trismus gradually improved, although the dysarthria persisted.[ncbi.nlm.nih.gov]
Jaw Pain
  • Two months after switching from risperidone to paliperidone, his eye blinking, light sensitivity, jaw pain, and trismus gradually improved, although the dysarthria persisted.[ncbi.nlm.nih.gov]
Orthostatic Hypotension
  • Orthostatic hypotension could lead to falls with the potential for fractures and other injuries.[pdr.net]
  • Dosage and Administration and see Orthostatic Hypotension under Cautions.)[drugs.com]
  • CV: tachycardia, chest pain, orthostatic hypotension, prolonged QT interval. EENT: rhinitis, sinusitis, pharyngitis, abnormal vision. GI: constipation, nausea, vomiting, dyspepsia, abdominal pain, anorexia. Metabolic: weight gain.[glowm.com]
  • Risperidone may cause a condition called orthostatic hypotension during the early phase of treatment (the first week or two).[medicinenet.com]
Blepharospasm
  • At one year after the start of this risperidone regimen, he exhibited severe blepharospasm symptoms (increased rate of eye blinking, light sensitivity) and oromandibular symptoms (trismus, jaw pain, dysarthria). He was diagnosed with Meige syndrome.[ncbi.nlm.nih.gov]
  • […] not known ejaculation dysfunction / Delayed / Incidence not known myasthenia / Delayed / Incidence not known photophobia / Early / Incidence not known conjunctival hyperemia / Early / Incidence not known conjunctivitis / Delayed / Incidence not known blepharospasm[pdr.net]
Motor Restlessness
  • These include dyskinesias such as repetitive, involuntary, and purposeless body or facial movements, Parkinsonism (cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially in the legs, and[library.neura.edu.au]
  • These disorders include akathisia (motor restlessness), dystonia (abnormal muscle tone), and tardive dyskinesia (involuntary and repetitive movements).[ncbi.nlm.nih.gov]
  • At each visit, the primary clinician inquired about health problems, intercurrent illness, and concomitant medications and administered a 32-item questionnaire concerning energy level, muscle stiffness, motor restlessness, bowel and bladder habits, sleep[nejm.org]
Persecutory Delusion
  • SUMMARY: A 19-year-old man with schizophreniform disorder was admitted to the emergency department experiencing command hallucinations and persecutory delusions.[ncbi.nlm.nih.gov]
Head Banging
  • There was a history of similar behavior involving head banging before the trial. Extension Phase Figure 2. Figure 2. Scores for Severity of Symptoms during the Extension Phase of the Trial.[content.nejm.org]
Agitation
  • Risperidone is a widely accessible antipsychotic that can be used to manage psychosis-induced aggression or agitation. OBJECTIVES: To examine whether oral risperidone alone is an effective treatment for psychosis-induced aggression or agitation.[ncbi.nlm.nih.gov]
  • Risperidone is a widely accessible antipsychotic that can be used to manage psychosis-induced aggression or agitation. Objectives: To examine whether oral risperidone alone is an effective treatment for psychosis-induced aggression or agitation.[cochrane.org]
Seizure
  • After the dosage was titrated to 6 mg/d, she experienced generalized seizure attacks.[ncbi.nlm.nih.gov]
  • Stop taking and see physician NOW: Seizures. Related Reading What is Risperidone? Tardive dyskinesia Heterocyclic antidepressants Click below to find more related articles on Risperidone.[psyweb.com]
  • Vol. 244, Pg. 685, 1988. rat LD50 intravenous 34300ug/kg (34.3mg/kg) BEHAVIORAL: TREMOR BEHAVIORAL: CONVULSIONS OR EFFECT ON SEIZURE THRESHOLD Kiso to Rinsho. Clinical Report.[chem.nlm.nih.gov]
Akathisia
  • Patients with comorbid tic disorders had the poorest rate of response and highest rate of akathisia.[ncbi.nlm.nih.gov]
  • The most common adverse reactions that were associated with discontinuation from clinical trials (causing discontinuation in 1% of adults and/or 2% of pediatrics) were nausea, somnolence, sedation, vomiting, dizziness, and akathisia” (see package insert[aap.org]
  • 10% Somnolence (40-45%) Insomnia (26-30%) Agitation (20-25%) Anxiety (10-15%) Headache (10-15%) Rhinitis (10-15%) Fatigue (18-31%) Parkinsonism (28-62%) Akathisia (5-11%) Increased appetite (4-44%) Vomiting (10-20%) Drooling ( Urinary incontinence (5-[reference.medscape.com]
Stupor
  • The general head space of risperidone is often described as one of sleepiness, emptiness, apathy, stupor and catatonia. The specific cognitive effects can be broken down into several components which progressively intensify proportional to dosage.[psychonautwiki.org]
  • […] increased CNS depression Sun exposure: increased risk of photosensitivity Patient monitoring Closely monitor neurologic status, especially for mood changes or suicidal ideation, neuroleptic malignant syndrome (high fever, sweating, unstable blood pressure, stupor[medical-dictionary.thefreedictionary.com]
Dysarthria
  • Two months after switching from risperidone to paliperidone, his eye blinking, light sensitivity, jaw pain, and trismus gradually improved, although the dysarthria persisted.[ncbi.nlm.nih.gov]
  • […] hyperprolactinemia / Delayed / 10.0 mania / Early / Incidence not known depression / Delayed / Incidence not known confusion / Early / Incidence not known dysphonia / Delayed / Incidence not known sleep-related behaviors / Early / Incidence not known dysarthria[pdr.net]

Workup

Prolonged QT Interval
  • BACKGROUND: Numerous structurally unrelated drugs, including antipsychotics, can prolong QT interval and trigger the acquired long QT syndrome (aLQTS). All of them are thought to act at the level of KCNH2, a subunit of the potassium channel.[ncbi.nlm.nih.gov]
  • Hyponatremia, hypokalemia, prolonged QT interval, widened QRS complex, and seizures also have been reported. There’s no specific antidote to risperidone overdose; institute appropriate supportive measures.[glowm.com]
  • People taking other medicines that can increase the risk of a 'prolonged QT interval' (see end of factsheet for examples).[netdoctor.co.uk]
  • QT interval Tardive dyskinesia Thrombotic thrombocytopenic purpura (TTP) Sleep apnea syndrome Urinary retention Blood and lymphatic system disorders: Anemia, granulocytopenia Cardiac disorders: Tachycardia, sinus bradycardia, sinus tachycardia, atrioventricular[reference.medscape.com]

Treatment

  • RESULTS: PANSS scores before treatment were comparable between treatment groups. On days 7, 15, 30, and 60 of the treatment, the differences between two treatment groups became evident.[ncbi.nlm.nih.gov]
  • Subjects were randomly assigned to either risperidone or placebo treatment groups. Drugs were administered over a 6-week treatment period in a double-blind manner.[psychopharmacology.com]

Prognosis

  • Dual diagnosis can have an adverse effect on treatment and prognosis of SMI.[ncbi.nlm.nih.gov]
  • Tomotaka Suzuki, Masayuki Takase, Toshihiro Moriyama, Hiroyuki Watanabe, Toyoaki Hirata, Makoto Asano and Masaomi Iyo, Impact of dopamine supersensitivity psychosis in treatment-resistant schizophrenia: An analysis of multi-factors predicting long-term prognosis[doi.org]

Etiology

  • The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM.[ncbi.nlm.nih.gov]
  • There were no significant differences in respect to age, gender, stage of disease, etiologies of delirium and sum of etiologies.[scielo.isciii.es]
  • Gynecomastia in German soldiers: etiology and pathology. GMS Interdiscip Plast Reconstr Surg. DGPW; 2012; 1: Doc 03. doi:10.3205/iprs000003 [CrossRef]. Shores LE.[healio.com]
  • Cambridge, Cambridge University Press Stein L, Wise CD. (1971): Possible etiology of schizophrenia: progressive damage to the noradrenergic reward system by 6-hydroxydopamine.[dx.doi.org]

Epidemiology

  • Principle mechanisms underlying venous thromboembolism: Epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 2003;70:7-30. [ PUBMED ] 3. Anderson FA Jr., Spencer FA. Risk factors for venous thromboembolism.[jmhhb.org]
  • Diagnosis, Epidemiology and Management of Mixed States in Bipolar Disorder. CNS Drugs, Vol. 29, Issue. 9, p. 725. CrossRef Google Scholar Berger, Michael Lewitzka, Ute and Seemüller, Florian 2015. Akutbehandlung manischer Episoden.[cambridge.org]
  • Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. Am J Epidemiol 2001 ; 154 : 854 -64. 20. Romano PS, Roos LL, Jollis JG.[dx.doi.org]
  • Barbui, New EMA report on paliperidone 3-month injections: taking clinical and policy decisions without an adequate evidence base, Epidemiology and Psychiatric Sciences, 10.1017/S2045796016001025, 26, 3, (231-233), (2016).[doi.org]
  • Epidemiology of Delirium. Dement Geriatr Cogn Disord 1999; 10(5): 315-318. [ Links ] 3. Lipowski ZJ. Delirium in the elderly patient. N Engl J Med 1989; 320(9): 578-582. [ Links ] 4. Bond SM, Neelon VJ, Belyea MJ.[scielo.isciii.es]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiological mechanisms implicated in the development of AEP in our patient seem to be associated with eotaxin and serotonin eosinophilic-specific chemoattracting action, through the serotoninergic action of risperidone.[ncbi.nlm.nih.gov]
  • Precise pathophysiologic understanding of the hematologic side effects of antipsychotics is lacking, although different mechanisms of action have been proposed. 3 Possible mechanisms when a patient is taking clozapine or olanzapine include: • direct toxic[mdedge.com]
  • Principle mechanisms underlying venous thromboembolism: Epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 2003;70:7-30. [ PUBMED ] 3. Anderson FA Jr., Spencer FA. Risk factors for venous thromboembolism.[jmhhb.org]

Prevention

  • Routine physical and laboratory examinations may prevent silent disease progression.[ncbi.nlm.nih.gov]
  • Researching Advancements in Cancer Vaccines Cancer vaccines can be used either in the prevention or the treatment of cancer.[news-medical.net]

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