Gupta Divya, OʼHara Chris
From the Department of Pediatrics, Penn State Hershey Medical Center, Hershey, PA.
Pediatr Emerg Care. 2019 Aug;35(8):e145-e146. doi: 10.1097/PEC.0000000000001889.
Aripiprazole is an atypical antipsychotic with partial agonism at dopamine and serotonin receptors. In pediatrics, it is approved to treat irritability associated with autistic disorder along with other neuropsychological conditions. Compared with other atypical antipsychotics, it has a favorable side effect profile, but overdose experience is limited.
A 3-year-old drug-naive patient accidentally ingested 200 mg of aripiprazole. This ingestion resulted in immediate lethargy with brief improvement 16 hours after ingestion and subsequent decline 2 hours later. Patient returned to baseline 72 hours after ingestion.
Unlike previous case reports, this patient displayed a biphasic course of somnolence. Previous reports have described delayed onset and prolonged sedation in response to an aripiprazole overdose. Current recommendations regarding monitoring after ingestion do not account for possible worsening of symptoms after improvement.
It is important to recognize the need for a longer observation period after a significant aripiprazole overdose as a variable course of somnolence may be witnessed.
阿立哌唑是一种非典型抗精神病药物，对多巴胺和5-羟色胺受体具有部分激动作用。在儿科，它被批准用于治疗与自闭症谱系障碍相关的易激惹以及其他神经心理状况。与其他非典型抗精神病药物相比，它具有良好的副作用特征，但过量用药的经验有限。
一名3岁未用过药的患者意外摄入了200毫克阿立哌唑。此次摄入导致立即出现嗜睡，摄入后16小时有短暂改善，随后2小时病情恶化。摄入72小时后患者恢复至基线状态。
与之前的病例报告不同，该患者表现出双相性嗜睡病程。之前的报告描述了阿立哌唑过量用药后出现延迟发作和延长的镇静作用。目前关于摄入后监测的建议未考虑到症状改善后可能出现的恶化情况。
认识到在阿立哌唑大量过量用药后需要更长观察期很重要，因为可能会出现嗜睡病程的变化。
