Akademik Veri Yönetim Sistemi
27. ulusal çocuk ve ergen ruh sağlığı ve hastalıkları kongresi, İzmir, Türkiye, 10 - 13 Mayıs 2017, ss.280
PP119/ A Rare Side Effect of Paliperidone: Dose Dependent Angioedema
Esen Yildirim Demirdogen, Gülsüm Yitik
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ataturk University,
Erzurum/Turkey
Introduction: Paliperidone, an atypical antipsychotic agent, is the most active metabolite of
risperidone which has been used frequently in treatment of many different mental illness for
years with an efficiency of safe and tolerable profile. Owing to paliperidone newly marketed,
its adverse (side) effects have appeared day by day. Angioedema is a life threatening condition
as to swelling of the deeper cutaneous and mucosal layers that can result dysphagia, respiratory
distress, and death because of laryngeal edema. Here, we report firstly a case of angioedema
related to paliperidone in an adolescent with psychotic disorder.
Case: A 18-year-old boy was referred to our clinic from Agri State Hospital. He has been
diagnosed with schizophrenia and his medical treatment has been started there. Because of the
failure of the treatment, he was directed for hospitalization.His treatment history revealed that
he had been treated with olanzapine (10-20 mg/day), risperidone (2 mg/day) and quetiapine
(500-600 mg/day). His compliance with treatment was poor.His physical examination at the
time admission to the our clinic was normal. On investigation there was no abnormality in
haemogram, serum electrolytes, renal and liver function test. His EEG and brainMRG were
assessed as normal.Quetiapine treatment was stopped. Considering the treatment
incompatibility of the patient, it was decided that oral paliperidone treatment should be started
and then passed to the injection form.Paliperidone 3 mg was started and the dose was slowly
increased.When the patient's paliperidone treatment increased 9 mg to 12 mg, the patient began
to complain of itching, rash, swelling of the eyes, respiratory distress.The patient was consulted
dermatology department and diagnosed with angioedema by them. They suggested stopping
paliperidone treatment. We stopped the treatment and passed to clozapine treatment. The
patient, after passed to clozapine treatment, was recovered from angioedema. No side effects
were observed with this treatment.
Discussion: There are many case reports of angioedema related toother atypical antipsychotic.
There is only one case reported angioedema related to paliperidone in literature. We have
presented a case of dose-dependent paliperidone related to angioedema in an adolescent for the
first time. According to Naranjo Adverse Reaction Scale its score was6, in other words, there is
a probable association between angioedema and paliperidone. This case indicates the need for
the awareness of this rare adverse effect of paliperidone among physicians as well as
psychiatrists.