The possibility of the treatment for long-acting injectable antipsychotics induced severe side effects

Am J Emerg Med. 2017 Aug;35(8):1211.e1-1211.e2. doi: 10.1016/j.ajem.2017.04.063. Epub 2017 Apr 27.

Abstract

We present the case of a 47-year-old man with schizophrenia who developed acute and persistent circulatory failure after receiving injections of paliperidone palmitate. We measured blood concentrations of paliperidone and performed resection of hip tissues, where paliperidone palmitate was suspected to be present, in order to reduce the side effects. Unfortunately, the resection could not save the patient from prolonged and severe side effects and he died of multiple organ failure. We suggest that resection of the tissues suspected of containing paliperidone palmitate can help reduce its severe side effects. However, identifying the site of injection is essential.

Keywords: Acute circulatory failure; Extrapyramidal symptoms; Hydrolysis; Long-acting injectable antipsychotics; Resection; Schizophrenia.

Publication types

  • Case Reports

MeSH terms

  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Buttocks
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Fatal Outcome
  • Humans
  • Injections, Intramuscular / adverse effects*
  • Japan
  • Male
  • Middle Aged
  • Multiple Organ Failure / chemically induced*
  • Paliperidone Palmitate / administration & dosage*
  • Paliperidone Palmitate / adverse effects
  • Patient Compliance / psychology
  • Schizophrenia / drug therapy*
  • Shock / chemically induced*

Substances

  • Antipsychotic Agents
  • Paliperidone Palmitate