title: Adverse effects of oral nonstimulant psychotropic medications in young children reported to a regional poison center.
abstract: BACKGROUND
  Use of nonstimulant psychotropic medications other than antidepressants in young children is reported to be increasing. The patient safety ramifications of this remain unclear.
  
  
  OBJECTIVE
  To evaluate the frequency of calls to a regional poison center reporting adverse drug effects and the level of medical attention required in young children who are receiving oral nonstimulant psychotropic medications.
  
  
  METHODS
  A retrospective review of 544 267 consecutive human exposure poison center records between 2000 and 2008 was conducted for cases of young children given nonstimulant psychotropic medications with therapeutic intent.
  
  
  RESULTS
  A total of 597 cases met criteria for analysis. Drugs involved were 286 risperidone, 133 clonidine, 114 quetiapine, 37 aripiprazole, 43 olanzapine, 29 ziprasidone, and 5 buspirone; two or more were involved in 250 cases. Reasons for exposure included excess dose given unintentionally (61%), wrong medication unintentionally (12%), adverse effects with correct dose (11%), excess dose intentionally (0.6%), therapeutic error by health-care provider (0.5%), and unclear circumstances (15%). Moderate effects (such as dystonic reaction) occurred in 34 patients at their usual dose (53% of 64) and in 15 at unintentionally excessive doses (4% of 361). Emergency department evaluation of 22% of the children resulted in 5% of the total being admitted to a non-intensive care unit (ICU) bed and 2% of all admitted to an ICU bed.
  
  
  CONCLUSIONS
  Dosing errors and adverse effects involving nonstimulant psychotropic medications are cause for concern in young children. Additional information about safety and optimal dosage of these medications is needed to guide appropriate use.
authors: Department of Pediatrics, Emory University, Atlanta, GA, USA. eiman144@yahoo.com
authors: Eiman
authors: E
authors: Abdulrahman
authors: Brian E
authors: BE
authors: Costello
authors: Michael A
authors: MA
authors: Deguzman
authors: Wafa'a
authors: W
authors: Al-Khamees
authors: Robert J
authors: RJ
authors: Geller