J Korean Soc Emerg Med.  2009 Aug;20(4):453-457.

A Case of Hemodynamically Unstable Bradycardia after Risperidone Overdose

• Kwon BJ
• Kim DB
• Yang JH
• Jang SW
• Cho EJ
• Seung KB
• Rho TH
• Kim JH
• Choi KB

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.

Keyword

Risperidone; Bradycardia; Trifascicular block

MeSH Terms

Bradycardia
Female
Humans
Hypertension
Hypotension
Phenylephrine
Receptors, Adrenergic, alpha
Receptors, Dopamine
Receptors, Histamine
Risperidone
Schizophrenia
Serotonin
Suicide
Tachycardia
Phenylephrine
Receptors, Adrenergic, alpha
Receptors, Dopamine
Receptors, Histamine
Risperidone
Serotonin