• J Emerg Med · Oct 2019

    Case Reports

    Accidental Pediatric Paliperidone Ingestion Resulting in Delayed Profound Tachycardia.

    • Heather A Borek and Nathan P Charlton.
    • Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.
    • J Emerg Med. 2019 Oct 1; 57 (4): e109-e111.

    BackgroundPaliperidone is an atypical antipsychotic that is approved to treat schizophrenia in patients 12 years of age and older. There are minimal data on the clinical effects of exposure in the < 12-year-old age group.Case ReportWe report the case of a 7-year-old girl who was accidentally dosed with paliperidone for 3 days. Her clinical course was notable for a dystonic reaction and profound sinus tachycardia, with a heart rate peaking at 201 beats/min. The tachycardia persisted for over 64 h after her last dose. The mechanism of tachycardia has not been elucidated and is likely multifactorial, with alpha blockade and anticholinergic effects probably contributing. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians should be aware that paliperidone ingestion in children may result in delayed, profound tachycardia and may require more prolonged observation times or admission to the hospital.Copyright © 2019 Elsevier Inc. All rights reserved.

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