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• W2037138410 abstract "Although accidental poisoning with atypical antipsychotics in children is 1 of the most important causes of morbidity after accidental ingestion of medications, the number of studies that have assessed the effects of acute exposure to this class of drugs is very limited. The aim of this study was to achieve a better characterization of the acute toxicity profile in young children of the common atypical antipsychotics clozapine, olanzapine, quetiapine, and risperidone. Multicenter retrospective analysis of cases with atypical antipsychotics intoxication in children <6 years, reported by physicians to German, Austrian, and Swiss Poisons Centres between January 1, 2001, and December 31, 2009. A total of 106 cases of intoxication (31 clozapine, 29 olanzapine, 12 quetiapine, and 34 risperidone) were analyzed. Mean age was 2.6 years (range, 0.8–5.5). There were 52 (49%) females, 43 (40.6%) males, and in 11 (10.4%) cases gender was not reported. No correlation between age and number of ingested pills was found (Spearman correlation coefficient, 0.16). Concerning the number of ingested pills, there was no significant difference between males and females (Wilcoxon test, P = 0.39). Overall toxicity was rated as severe in 2 (1.9%), moderate in 28 (26.4%), and minor in 47 (44.3%) cases according to the Poisoning Severity Score. Twenty-eight (26.4%) cases were asymptomatic. No fatalities were recorded. Neurological and cardiovascular symptoms were predominating. Minor reduction in vigilance (Glasgow Coma Scale score >9) (62.3%) was the most frequently reported symptom, followed by miosis (12.3%) and mild tachycardia (10.4%). Extrapyramidal motor symptoms were observed in 1 case (0.9%) after ingestion of 2 mg (0.1 mg/kg) of risperidone. Electrocardiography was performed in 32 (30.2%) children: 3 (2.8%) showed extrasystoles, and in 1 (0.9%) case a prolonged QTc interval (468 ms) was recorded after the ingestion of 150 mg (13.6 mg/kg) of quetiapine. For clozapine, the lowest dose causing objective symptoms or signs was 0.8 mg/kg, resulting in aggressiveness, ataxia, dysarthria, and somnolence; for olanzapine, 0.4 mg/kg resulting in ataxia and somnolence; for quetiapine, 3.1 mg/kg resulting in ataxia and somnolence; and for risperidone, 0.05 mg/kg resulting in somnolence and mild tachycardia. In most cases, surveillance and supportive care were sufficient to achieve a good outcome, and all children made a full recovery. Most children poisoned with the atypical antipsychotics clozapine, olanzapine, quetiapine, and risperidone had a benign clinical course without sequelae. Extrapyramidal side effects were rare, and the only case reported was caused by risperidone. Symptomatic patients should be monitored for central nervous system depression, and an electrocardiogram should be obtained." @default.
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• W2037138410 date "2013-08-01" @default.
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• W2037138410 title "PP234—Intoxication with atypical antipsychotics in young children: A multicentre analysis of poisons centres data" @default.
• W2037138410 doi "https://doi.org/10.1016/j.clinthera.2013.07.274" @default.
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