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Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect
Antipsychotic medications have been well-established to potentially cause extrapyramidal side effects (EPS) including hyperkinesia, tremor, dyskinesia, dystonia, and parkinsonism. Rhabdomyolysis secondary to extrapyramidal symptoms in patients under antipsychotics is a relatively rare presentation t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531761/ https://www.ncbi.nlm.nih.gov/pubmed/36225523 http://dx.doi.org/10.7759/cureus.28771 |
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author | Allena, Nishant Doppalapudi, Sai Khanal, Sneha Tank, Steven Nasr, Rabih |
author_facet | Allena, Nishant Doppalapudi, Sai Khanal, Sneha Tank, Steven Nasr, Rabih |
author_sort | Allena, Nishant |
collection | PubMed |
description | Antipsychotic medications have been well-established to potentially cause extrapyramidal side effects (EPS) including hyperkinesia, tremor, dyskinesia, dystonia, and parkinsonism. Rhabdomyolysis secondary to extrapyramidal symptoms in patients under antipsychotics is a relatively rare presentation to be observed in patients. In this report, we present a 64-year-old female with rhabdomyolysis following a once-monthly injection of long-acting injectable (LAI) paliperidone palmitate (Invega Sustenna). The patient developed extrapyramidal symptoms one day after the paliperidone injection. She presented with acute dystonia in the form of antecollis, without any evidence of generalized myalgia or kidney involvement. Laboratory investigations demonstrated a creatine kinase (CK) level of 3239 unit/L on admission. The patient’s symptoms were resolved after the administration of benztropine and cyclobenzaprine and CK levels improved after IV hydration. A high index of suspicion in the investigation of rhabdomyolysis for patients presenting with extrapyramidal symptoms being treated with long-acting injectable antipsychotics leads to prompt diagnosis, early treatment, and reduction in renal and cardiac toxicities in the aforementioned population. |
format | Online Article Text |
id | pubmed-9531761 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-95317612022-10-11 Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect Allena, Nishant Doppalapudi, Sai Khanal, Sneha Tank, Steven Nasr, Rabih Cureus Internal Medicine Antipsychotic medications have been well-established to potentially cause extrapyramidal side effects (EPS) including hyperkinesia, tremor, dyskinesia, dystonia, and parkinsonism. Rhabdomyolysis secondary to extrapyramidal symptoms in patients under antipsychotics is a relatively rare presentation to be observed in patients. In this report, we present a 64-year-old female with rhabdomyolysis following a once-monthly injection of long-acting injectable (LAI) paliperidone palmitate (Invega Sustenna). The patient developed extrapyramidal symptoms one day after the paliperidone injection. She presented with acute dystonia in the form of antecollis, without any evidence of generalized myalgia or kidney involvement. Laboratory investigations demonstrated a creatine kinase (CK) level of 3239 unit/L on admission. The patient’s symptoms were resolved after the administration of benztropine and cyclobenzaprine and CK levels improved after IV hydration. A high index of suspicion in the investigation of rhabdomyolysis for patients presenting with extrapyramidal symptoms being treated with long-acting injectable antipsychotics leads to prompt diagnosis, early treatment, and reduction in renal and cardiac toxicities in the aforementioned population. Cureus 2022-09-04 /pmc/articles/PMC9531761/ /pubmed/36225523 http://dx.doi.org/10.7759/cureus.28771 Text en Copyright © 2022, Allena et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Allena, Nishant Doppalapudi, Sai Khanal, Sneha Tank, Steven Nasr, Rabih Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title | Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title_full | Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title_fullStr | Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title_full_unstemmed | Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title_short | Acute Dystonia With Rhabdomyolysis Induced by Paliperidone Palmitate: A Rare Adverse Effect |
title_sort | acute dystonia with rhabdomyolysis induced by paliperidone palmitate: a rare adverse effect |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531761/ https://www.ncbi.nlm.nih.gov/pubmed/36225523 http://dx.doi.org/10.7759/cureus.28771 |
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