Paliperidone/valproate semisodium
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Hypothermia: case report A 68-year-old man developed hypothermia while receiving treatment with paliperidone and valproate semisodium [divalproex sodium] [route not stated] for schizophrenia. The man, who had a medical history of chronic kidney disease, schizophrenia, hyperlipidaemia and hypertension, was shifted to the emergency department (ED) due to a sudden onset of drowsiness from a nursing home. On presentation, he was on medications included IM paliperidone [paliperidone palmitate] 234mg for 28 days (received a day before this admission) and valproate semisodium 1500mg daily (500mg in morning and 1000mg at bedtime) along with other medications. On arrival to the ED, his body temperature was 91.8°F. His initial mental status examination showed an obese man not oriented to time/place/ person, not following commands and arousable with only painful stimuli. Laboratory examination revealed increased levels of blood urea nitrogen and serum creatinine. He was reported to have sinus bradycardia with Q-T interval corrected (QTc) 562ms on ECG. Further, he was admitted to ICU for medical stabilisation. The man was treated with fluid resuscitation and Bair Hugger Normothermia System. On day 2 of admission, he developed respiratory failure and hence required intubation. Consequently, he became stable afer 7 days of ICU treatment and was shifted to the inpatient psychiatric unit. It was reported that he had a similar episode of hypothermia with cardiac arrest necessitate cardiopulmonary resuscitation around a month ago following a similar injection of paliperidone. Hence, hypothermia was supposed to be due to injectable paliperidone. He received haloperidol. Afterwards, he remained in the psychiatric unit for next 4 weeks. No further episodes of hypothermia were observed. Hirapara K, et al. Hypothermia Associated With Paliperidone Depot Injection in Schizophrenia Patient: A Case Report. Journal of Clinical Psychopharmacology 40: 86-87, 803514610 No. 1, Jan-Feb 2020. Available from: URL: http://doi.org/10.1097/JCP.0000000000001155
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Reactions 14 Nov 2020 No. 1830
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