Oedema Associated with Risperidone
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Clin Drug Invest 2002; 22 (6): 411-414 1173-2563/02/0006-0411/$25.00/0 © Adis International Limited. All rights reserved.
Oedema Associated with Risperidone A Case Report and Literature Review Lut Tamam, Nurgul Ozpoyraz and Mehmet Unal Department of Psychiatry, Cukurova University Faculty of Medicine, Adana, Turkey
Risperidone, a benzisoxazole derivative, is a novel antipsychotic drug that binds with high affinity to serotonin type 2 (5-HT2), dopamine D2 and α1-adrenergic receptors, and causes antagonism at these receptor sites.[1,2] Risperidone has been proven to be effective in psychotic disorders, aggression and several other psychiatric disorders.[1] The most frequent adverse reactions observed during clinical trials with risperidone are insomnia, agitation, extrapyramidal disorders, anxiety and headache. Apart from these events, several other adverse reactions have been observed with this drug during pre- and postmarketing periods,[2] of which oedema has been reported in several case reports[3-8] and more recently in a large-scale study.[9] Although the aetiology of this adverse effect has not been established yet, new experiences, studies and case reports would improve our understanding of the causes of oedema associated with risperidone. In this report, we present a case of oedema due to risperidone, and review the associated literature. Case Report A 27-year-old woman who had been treated for schizophrenia for the previous two years was admitted to our inpatient clinic for the second time. At the time of the second admission, she had persecutory and referential delusions of being abducted by strangers, as well as prominent auditory hallucinations. Tests of her mental abilities revealed slowing down in thought associations with blocks in her speech. She seemed paranoid and reluctant to answer questions. However, she
clearly described her delusions of being followed and claimed that her parents had tried to kill her by adding poison to her meals for the last couple of days. Psychomotor retardation was also remarkable; however, the medical history of the patient was unremarkable. She had no history of oedema, congestive heart failure or any other cardiac dysfunction, hepatic or renal dysfunction, thyroid disorder or any other peripheral vascular disease. At the time of admission, her physical and laboratory examinations were within normal limits in all domains; her bodyweight was 48kg and her height was 160cm. A psychiatric history of the patient revealed that she had been hospitalised about 2 years previously with the same complaints (the first time in our inpatient clinics), during which she had been treated with risperidone 2 mg/day after 10 sessions of bilateral electroconvulsive therapy. She had been receiving risperidone 2 mg/day ever since she was discharged from hospital. She did not experience any adverse effects related to risperidone except for mild dystonia and akathisia, which were treated with a low dose of biperiden (2 mg/day) on an asneeded basis. Although her mental status was stable for 1
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