paliperidone-palmitate and Child-Behavior-Disorders

Oculogyric crises are considered to be a form of focal dystonia and can be observed as reactions to pharmaceuticals. The signs and symptoms may be confused with epileptic crises.. To describe the clinical features and progress of patients with pharmaceutical-related oculogyric crises and to carry out a review of the topic.. We conducted a retrospective, descriptive study of four patients evaluated in the neurology service due to oculogyric crises. The patients had been diagnosed with an associated conduct disorder requiring treatment with antipsychotic drugs. The episodes of oculogyric crises did not correlate with the findings in the electroencephalogram. They responded well to the reduction in dosage or to withdrawal of the apparent causing agent.. The clinical picture does not present only in patients treated with antipsychotics but is also linked with other pharmaceuticals that are frequently used in daily paediatric practice. When oculogyric crises are the reason for visiting, differential diagnoses must be taken into account in order to avoid unnecessary studies and to carry out an appropriate therapeutic management.

Topics: Adolescent; Anticonvulsants; Antipsychotic Agents; Aripiprazole; Child; Child Behavior Disorders; Child, Preschool; Dopamine; Dopamine Antagonists; Down Syndrome; Dyskinesia, Drug-Induced; Dystonic Disorders; Electroencephalography; Epilepsy; Female; Fragile X Syndrome; Humans; Intellectual Disability; Isoxazoles; Male; Methotrimeprazine; Ocular Motility Disorders; Paliperidone Palmitate; Piperazines; Pyrimidines; Quinolones; Risperidone; Substance Withdrawal Syndrome; Translocation, Genetic; Valproic Acid

The aim of this prospective naturalistic study was to examine for the first time the relationship between dosage, serum concentration and clinical outcome in children and adolescents with impulsive-aggressive symptoms during risperidone therapy.. Steady state trough serum concentrations of risperidone and 9-hydroxyrisperidone (the active moiety) were measured in 103 subjects. The therapeutic effect was assessed by the clinical global impression improvement subscale and side effects by the Udvalg for Kliniske Undersogelser-side effect rating scale.. We found a linear relationship between the risperidone dose and the serum concentration of the active moiety (Spearman rho=0.53) and no correlation between the serum concentration and either the therapeutic effect or side effects. There was no effect of gender and co-medication.. This study has the typical limitations of naturalistic studies, therefore our results should be interpreted with caution. Based on the serum concentrations at the therapeutically effective dose range (0.25-1.5 mg/day) we obtained first information on a possibly appropriate therapeutic serum range for the risperidone treatment of children and adolescents with impulsive-aggressive symptoms. Further studies with greater sample sizes are needed to validate our results and to examine the influence of genetic polymorphisms on the serum concentration of risperidone.

Topics: Adolescent; Age Factors; Aggression; Antipsychotic Agents; Child; Child Behavior Disorders; Disruptive, Impulse Control, and Conduct Disorders; Dose-Response Relationship, Drug; Female; Humans; Isoxazoles; Linear Models; Male; Paliperidone Palmitate; Prospective Studies; Psychiatric Status Rating Scales; Pyrimidines; Risperidone; Sex Factors; Treatment Outcome