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J Korean Soc Emerg Med > Volume 20(4); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(4): 453-457.
A Case of Hemodynamically Unstable Bradycardia after Risperidone Overdose
Beom June Kwon, Dong Bin Kim, Jin Hong Yang, Sung Won Jang, Eun Ju Cho, Ki Bae Seung, Tai Ho Rho, Jae Hyung Kim, Kyu Bo Choi
Division of Cardiology, Department of Internal Medicine, St.Paul's Hospital, College of Medicine, The Catholic University, Seoul, Korea. bjwow@freechal.com
ABSTRACT
Risperidone is an atypical antipsychotic medication commonly used to treat psychotic illness, such as schizophrenia. It has strong serotonin and dopamine receptor antagonism and antagonist activity at alpha-adrenergic receptors and histamine receptors. An overdose of risperidone can cause tachycardia, hypertension, hypotension, prolonged QT interval, and bradycardia. Risperidone overdose is rare,but life-threatening. Here, we present the rare case of a 33- year-old woman who ingested risperidone overdose for the purposes of suicide, developing hemodynamically unstable bradycardia with trifascicular block, leading to fatality. Lessons from our case report are of urgent consideration for temporary pacemaker insertion, and use of alpha-1 agonist, such as phenylephrine in cases of hemodynamically unstable bradycardia by risperidone overdose. Prompt and appropriate identification and interventions are essential for the successful management of risperidone overdose.
Key words: Risperidone, Bradycardia, Trifascicular block
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