Risperidone Induce Recurrence of Severe Acute Respiratory Distress in a Patient with Psychotic Disorders

Abstract

Mrs. R, 61-years-old was admitted into the department on July 2015 with a history of major paranoid psychosis. Notion of asthma was indicated in the medical file without any specific treatment. At the admission she received risperidone 4 mg/day and duloxetine since one year. Between October 2015 and June 2016, the patient presented 19 episodes of respiratory decompensation, six of them required transfer in the emergency unit, and 3 in the intensive care unit (ICU) with the assistance of mechanical ventilation. During the last episode, transfer in the intensive care unit was refused by the ICU physician because of the high frequency of recurrence and the difficulty to extube the patient. “End of life” was therefore considered. Nevertheless, medical physician in charge of the patient decided to continue symptomatic treatment and to stop all anti-psychotic drugs susceptible to deteriorate respiratory disease. On the first day we observed a dramatic improvement and no recurrence occurred since now 3 months without any treatment. Between the admission and the occurrence of respiratory decompensation, hypereosinophilia (1610/mL) was observed with recovery in normal value after interruption of risperidone. We also noted an improvement of functional respiratory test. In conclusion, risperidone is an anti-psychotic drug largely used. Severe side effect may endanger life-threatening as described in this case. The recurrence of severe acute respiratory distress without induced factors founded needs to discuss the potential role of this drug.

Disclosure of interest

The authors have not supplied their declaration of competing interest.