title: Atypical antipsychotic poisoning in young children: a multicentre analysis of poisons centres data.
abstract: Although paediatric patients frequently suffer from intoxications with atypical antipsychotics, the number of studies in young children, which have assessed the effects of acute exposure to this class of drugs, is very limited. The aim of this study was to achieve a better characterization of the acute toxicity profile in young children of the atypical antipsychotics clozapine, olanzapine, quetiapine, and risperidone. We performed a multicentre retrospective analysis of cases with atypical antipsychotics intoxication in children younger than 6 years, reported by physicians to German, Austrian, and Swiss Poisons Centres for the 9-year period between January 1, 2001 and December 31, 2009. One hundred and six cases (31 clozapine, 29 olanzapine, 12 quetiapine, and 34 risperidone) were available for analysis. Forty-seven of the children showed minor, 28 moderate, and 2 severe symptoms. Twenty-nine cases were asymptomatic. No fatalities were recorded. Symptoms predominantly involved the central nervous and cardiovascular systems. Minor reduction in vigilance (Glasgow Coma Scale score >9) (62 %) was the most frequently reported symptom, followed by miosis (12 %) and mild tachycardia (10 %). Extrapyramidal motor symptoms were observed in one case (1 %) after ingestion of risperidone. In most cases, surveillance and supportive care were sufficient to achieve a good outcome, and all children made full recovery.
  
  
  CONCLUSIONS
  Paediatric antipsychotic exposure can result in significant poisoning; however, in most cases only minor or moderate symptoms occurred and were followed by complete recovery. Symptomatic patients should be monitored for central nervous system depression and an electrocardiogram should be obtained.
authors.affiliation: Division of Science, Swiss Toxicological Information Centre, Associated Institute of the University of Zurich, Freiestrasse 16, Zurich, CH-8032, Switzerland.
authors.forename: Marianne
authors.initials: M
authors.lastname: Meli
authors.forename: Christine
authors.initials: C
authors.lastname: Rauber-Lüthy
authors.forename: Petra
authors.initials: P
authors.lastname: Hoffmann-Walbeck
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Reinecke
authors.forename: Dagmar
authors.initials: D
authors.lastname: Prasa
authors.forename: Uwe
authors.initials: U
authors.lastname: Stedtler
authors.forename: Elke
authors.initials: E
authors.lastname: Färber
authors.forename: Dieter
authors.initials: D
authors.lastname: Genser
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
authors.forename: Gerd A
authors.initials: GA
authors.lastname: Kullak-Ublick
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
mesh_terms: D014150:Antipsychotic Agents / Q000506:poisoning*; D001317:Austria; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013557:Switzerland
chemical_list: D014150:Antipsychotic Agents