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Paliperidone induced sinus tachycardia in a patient with first episode of psychosis (FEP)

Published online by Cambridge University Press:  13 August 2021

A. Sarafopoulos ,
D. Antoniadis  and
V. Karpouza
A. Sarafopoulos*
Affiliation:
4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece 4th Picu, Psychiatric Hospital of Thessaliniki, Thessaloniki, Greece
D. Antoniadis
Affiliation:
4th Picu, Psychiatric Hospital of Thessaliniki, Thessaloniki, Greece
V. Karpouza
Affiliation:
4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
*
*Corresponding author.

Abstract

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Introduction

This is a presentation of the FEP of a 23 y.o. patient. The patient had a Duration of Untreated Psychosis (DUP) of 6 months and Duration of Untreated Illness (DUI) of six years. The therapeutic response and the adverse effects of Paliperidone are being described.

Objectives

To investigate the tolerance of Paliperidone in a patient with FEP.

Methods

The patient was assessed regularly by the psychiatric team consisting of a CT doctor and one General Adult Consultant. Appropriate psychological assessments and investigations took place.

Results

Upon admission the patient appeared guarded. She also presented with weight loss and dehydration. Initial PANSS score was 173, positive subscale 41. The patient was initially treated with monotherapy 6mg of Paliperidone. However, the heart rate was around 100 bpm culminating as high as 156 bpm. The ECG indicated sinus tachycardia. The patient presented with serious EPSs and diarrhea. Simpson-Angus Scale score 10. Metoprolol 25mg was prescribed twice a day. The clinical team proceeded in cross titration replacing Paliperidone with Olanzapine. A brain CT scan was also performed, unremarkable. After 10 days of therapy the PANSS score reduced to 102, positive subscale 21.

Conclusions

Initial sinus tachycardia is a common adverse effect of Paliperidone. However in this case the tachycardia was refractory in time even after the 7th day, making an alternative SGA trial necessary.

Disclosure

No significant relationships.

Keywords

paliperidoneFEPTachycardia
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S777
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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