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Case Reports: Reminder of important clinical lesson
Recognising side effects of antipsychotics in children with intellectual disabilities
  1. Jessica Lee1,
  2. Rosie Shepperd2,
  3. Martin Smith3 and
  4. Geetha Anand1
  1. 1Acute Paediatrics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  2. 2Child and Adolescent Mental Health Services Learning Disability Team, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, Oxford, UK
  3. 3Paediatric Neurology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Dr Jessica Lee; jessicauntzlee{at}doctors.org.uk

Abstract

Risperidone and aripiprazole are increasingly used for behavioural indications in children and adolescents with intellectual disabilities, including autism. Although there are some reports in literature, the side effect profile in this population remains poorly defined and there is a need to raise awareness among clinicians across specialties. We present two patients with significant intellectual disabilities who developed extrapyramidal side effects (EPSE) including oculogyric crisis following risperidone and aripiprazole use. The onset of these side effects can be insidious and the non-specific nature of the presentation, for example, poor mobility and increased drooling on a background of severe intellectual disability, can lend itself to delay in recognition and reporting by families. There is also reduced awareness among paediatricians, which can further delay the treatment of this reversible condition. There needs to be ongoing vigilance for EPSE as they can develop years after treatment has been initiated.

  • Paediatrics (drugs and medicines)
  • Child and adolescent psychiatry (paediatrics)
  • Unwanted effects / adverse reactions

https://doi.org/10.1136/bcr-2022-251974

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    Footnotes

    • Contributors JL, RS, MS and GA contributed to planning, conduct and reporting of this work, give approval for its publication and agree to be accountable for all aspects of this work. GA, MS and RS were responsible for clinical care provision for the two teenagers described in this report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.