Table 2.
Overview of results from case reports
| Study | Publication type | Sex | Age | Intellectual functioning | History of seizures | Relevant comorbidities | Psychiatric disorder(s) | Medication regime | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Trial # | Antipsychotic(s), daily dose | Comedication, daily dose | Adverse effects and symptoms attributed to antipsychotic treatment | ||||||||
| Aksu and Demirkaya (2016) | Article | F | 15 | IQ 48 | Hypocalcemic convulsions | Thymus aplasia, hypoparathyroidism, hypocalcemia, kidney aplasia | Sz | 1 | Clozapine 500 mg | – | Generalized tonic–clonic convulsion |
| 2 | Clozapine 250 mg | Valproic acid 500 mg | Mild sedation, sialorrhea | ||||||||
| Angelopoulos et al. (2017) | Article | M | 19 | IQ 50 | – | Cardiomegaly, bilateral basal ganglia calcifications | Sz | 1 | Risperidone 20 mg | Biperiden 6 mg, Topiramate 100 mg | Gaps in memory, dizzy |
| 2 | Olanzapine 50 mg | Clonazepam 2 mg | Gaps in memory | ||||||||
| 3 | Haloperidol 60 mg, olanzapine 20 mg | Biperiden 6 mg, clonazepam 2 mg | Gaps in memory | ||||||||
| 4 | Clozapine 300 mg | Clonazepam 1 mg | – | ||||||||
| Biswas et al. (2008) | Article | F | 34 | Mild ID | – | Musculo‐skeletal abnormalities | Depression, borderline personality disorder, psychosis | 1 | Clozapine dose NR | – | Hyper salivation |
| Boot et al. (2015) | Article | M | 45 | Moderate to severe ID | – | – | Sz | 1 | Quetiapine 700 mg | – | Seizures and oculogyric crisis |
| 2 | Aripiprazole 15 mg | – | Generalized epileptic seizures | ||||||||
| 3 | Clozapine 150 mg | – | Myoclonus, cogwheel rigidity, rest tremors bilaterally | ||||||||
| M | 54 | Mild ID | – | Tardive dyskinesia as a result of previous antipsychotic treatments | Sz | 1 | Clozapine 300 mg | Benztropine 2 mg | Myoclonic jerks, seizure | ||
| 2 | Clozapine 200 mg | Clonazepam 3 mg | Hand tremor | ||||||||
| 3 | Clozapine 400 mg | Benztropine | Tonic–clonic seizures | ||||||||
| 4 | Clozapine dose NR | Gabapentin 3,000 mg, clonazepam 1.5 mg, calcium, vitamin D | Rest tremor | ||||||||
| M | 38 | Mild ID | – | – | Sz | 1 | Olanzapine 17.5 mg | Fluoxetine 20 mg, domperidone 40 mg, calcium, vitamin D | Decreased facial expression, slowness, rigidity, decrease in restlessness, periodic oculogyric movements | ||
| Borders et al. (2017) | Article | F | 34 | IQ 87 | – | Right aortic arch, cerebellar cyst, scoliosis, hypocalcaemia | ASD, sz, generalized anxiety disorder, panic disorder | 1 | Quetiapine dose NR | – | Sedation |
| 2 | Aripiprazole dose NR | – | Shaking and claw‐like spasms | ||||||||
| 3 | Asenapine 10 mg | Clonazepam 1 mg | Dystonic reactions, including shaking and claw‐like spasms of the hand | ||||||||
| Briegel (2007) | Abstract | M | 10 | – | – | – | Sz | 1 | Clozapine dose NR | – | Seizure |
| Butcher et al. (2014) | Abstract | M | 54 | – | – | – | Sz | 1 | Clozapine dose NR | – | Progressive parkinsonism (including bradykinesia, rigidity, and right‐sided tremor) and myoclonus |
| Demily et al. (2017) | Article | M | 37 | – | – | – | Sz | 1 | Quetiapine 300 mg | – | Weight loss |
| Engebretsen et al. (2015) | Article | F | 19 | – | Graves' disease | Schizoaffective disorder | 1 | Olanzapine dose NR | Weight gain, increased blood sugar, leukopenia | ||
| 2 | Ziprasidone dose NR | – | – | ||||||||
| 3 | Aripiprazole dose NR | – | – | ||||||||
| 4 | Amisulpride dose NR | – | Unspecified severe side effects | ||||||||
| 5 | Quetiapine dose NR | – | Tiredness | ||||||||
| 6 | Haloperidol dose NR | – | Weight loss, compulsions | ||||||||
| 7 | Clozapine dose NR | – | Severe tremor, leukopenia | ||||||||
| 8 | Risperidone dose NR | – | – | ||||||||
| Faedda et al. (2015) | Article | F | 15 | IQ 58 | – | Asthma | Possible ADHD, anxiety disorder NOS | 1 | Olanzapine 15 mg | Lorazepam 12 mg | Weight gain (30 pounds in 3 months) |
| 2 | Ziprasidone 120 mg | – | Body aches and tight throat with swallowing problems | ||||||||
| Farrell et al. (2018) | Article | M | 41 | IQ 80 | – | Huntington's disease, hyperkinetic movement disorder (oro‐lingual‐buccal dyskinesia, choreoathetosis, mingled with repetitive grabbing movements, and posturing of the left upper extremity) | Sz | 1 | Perphenazine dose NR | Lithium | – |
| 2 | Perphenazine, olanzapine, clozapine; doses NR | – | Thrombocytopenia | ||||||||
| 3 | Clozapine dose NR | – | Obesity | ||||||||
| 4 | Clozapine, Risperidone; doses NR | Fluoxetine | Thrombocytopenia, obesity | ||||||||
| 5 | Clozapine, Ziprasidone dose NR | – | – | ||||||||
| Gagliano and Masi (2009) | Article | F | 7 | – | Idiopathic precocious puberty, high levels of B‐humanchorionic gonadotropin and estradiol | Sz | 1 | Risperidone 1.5 mg, Aripiprazole 7.5 mg | – | Mild and transient nausea | |
| 2 | Clozapine 150 mg, Aripiprazole 8.7 mg | Tamoxifen 10 mg | Psychomotor agitation | ||||||||
| 3 | Clozapine 150 mg, Aripiprazole 10 mg | Valproic 900 mg, Tamoxifen 10 mg | Neutropenia | ||||||||
| 4 | Clozapine 150 mg, Aripiprazole 15 mg | Lithium 600 mg, Tamoxifen 10 mg | Sedation, enuresis, increased appetite | ||||||||
| 5 | Clozapine 200 mg, Aripiprazole 15 mg | Lithium 600 mg, Tamoxifen 10 mg | Weight gain, tachycardia | ||||||||
| Gladston and Clarke (2005) | Article | M | 32 | IQ 66 | – | Palate abnormality | Schizoaffective disorder | 1 | Clozapine 300 mg | – | Hypersalivation, constipation, myoclonic‐epilepsy |
| 2 | Clozapine 300 mg | Sodium valproate 300 mg | Myoclonic jerks | ||||||||
| 3 | Clozapine 300 mg | Sodium valproate 1,200 mg | – | ||||||||
| Gothelf et al. (1999) | Article | F | 35 | – | Psychosis | 1 | Clozapine 200 mg | Valproate 600 mg | Unspecified myoclonic jerks | ||
| Jacobson and Turkel (2013)a | Article | F | 2 | – | A prior seizure | Congenital heart defect, recurrent pneumonia, pulmonary hypertension, and right heart failure, recently developed choreiform movements | Delirium | 1 | Fluphenazine dose NR | Fentanyl, midazolam, Lorazepam, chloral hydrate, Vecuronium, transdermal clonidine, diphenhydramine, Pressors, anticoagulants, diuretics, sildenafil | Elevated liver enzymes |
| Kontoangelos et al. (2015) | Article | M | 18 | – | – | Behavioral disorders | 1 | Haloperidol 2 mg | – | Cervical dystonia, torticollis, continuous twisting movements of the trunk and limbs, dysarthria | |
| 2 | Quetiapine 200 mg | – | |||||||||
| Kook et al. (2010) | Article | F | 25 | – | Hypothyroidism, hypoparathyroidism | Sz | 1 | Risperidone 8 mg | Levothyroxine and vitamin D | Generalized tonic–clonic seizures | |
| Krahn et al. (1998) | Article | M | 27 | IQ 70 | – | Ventricular septal defect and persistent ductus arteriosus, Parkinson's disease | Sz | 1 | Fluphenazine (decanoate) | – | Muscle rigidity, oral‐buccal movements, tremors of tongue and upper extremities, drug‐induced parkinsonism |
| 2 | Clozapine 125 mg | Levocarbidopa 100/25 mg, amantadine 100 mg, Benztropine 2 mg | Resting tremor of all limbs, generalized bradykinesia, generalized tonic–clonic seizures | ||||||||
| Le Page (2006) | Article | F | 17 | Borderline intellectual functioning | – | Psychosis | 1 | Clozapine dose NR | – | Agranulocytosis | |
| 2 | Haloperidol dose NR | Sodium valproate | Thrombocytopenia | ||||||||
| Molebatsi and Olashore (2018) | Article | F | 13 | – | Complex congenital heart defect | Sz | 1 | Haloperidol 3 mg | – | Akathisia, sialorrhea | |
| 2 | Olanzapine 5 mg | – | – | ||||||||
| Muller and Fellgiebel (2008) | Article | F | 41 | Mild ID | – | Bilateral hearing loss, ventricular tachycardia | Psychosis | 1 | Quetiapine 400 mg | – | – |
| O'Hanlon et al. (2003) | Article | F | 23 | Mild ID | Right bundle‐branch block, lymphopenia, thrombocyto‐penia | Psychosis | Previous trials | Haloperidol, Thiothixene, Risperidone, Thioridazine, olanzapine, Quetiapine; doses NR | – | Hypertension, seizure disorder | |
| 1 | Thioridazine 50 mg | Propranolol 20 mg, Bromocriptine 2.5 mg, phenytoin 200 mg | – | ||||||||
| 2 | Olanzapine 30 mg | Propranolol 20 mg, Bromocriptine 2.5 mg, phenytoin 200 mg | Worsening of chronic thrombocytopenia | ||||||||
| Ohi et al. (2013) | Article | F | 48 | IQ 80 | Thymic hypoplasia, hypocalcemia bilateral basal ganglia calcifications, thrombocytopenia | Sz | 1 | Risperidone 1,200 mg | – | Generalized spasm | |
| Perret et al. (2017) | Article | F | 27 | IQ 100 | Multiple congenital malformations | Bipolar disorder type 1, psychotic episode | 1 | Olanzapine 10 mg | – | Weight gain, tremor, unspecified dystonia | |
| 2 | Risperidone dose NR | – | Weight gain, tremor, unspecified dystonia | ||||||||
| Praharaj and Sarkar (2010) | Article | M | 21 | IQ 85 | Bifascicular block, ventricular ejection fraction 63% | Predominantly manic symptoms | 1 | Olanzapine 20 mg | Sodium valproate 2 mg | Thrombocytopenia | |
| 2 | Clozapine 300 mg | ‐ | Thrombocytopenia | ||||||||
| Ruhe et al. (2018) | Article | M | 17 | – | – | Hypothyroidism | Bipolar disorder, schizophrenia or schizoaffective disorder | 1 | Clozapine 175 mg | Cariprazine 6 mg | Mild diarrhea, thrombocytopenia, neck stiffness, sore throat, myocarditis |
| Levothyroxine 100 mg | |||||||||||
| Sachdev (2002) | Article | M | 22 | Mild to moderate ID | Epileptic seizures | – | Psychotic disorder | 1 | Chlorpromazine 100 mg | – | Drowsiness, hypotension |
| 2 | Olanzapine 10 mg | – | Tremulous, hypotension, myoclonus of the limbs | ||||||||
| Starling and Harris (2008) | Article | F | 16 | Moderate ID | Epilepsy with myoclonic jerks and generalized seizures | Ventricular septal defect, poor motor skills, cortical, and cerebellar atrophy | Repetitive behavior, angry outbursts, depressed mood, auditory hallucinations | 1 | Olanzapine 7.5 mg | – | Weight gain |
| 2 | Aripiprazole 20 mg | Sodium valproate 800 mg | Neuroleptic malignant syndrome | ||||||||
| F | 15 | – | – | Gray matter heterotopia frontal horn of the lateral ventricles bilaterally, hyperdense foci in right frontal horn on MRI | Depressed mood, paranoid delusions, and hallucinations | 1 | Olanzapine 20 mg | Fluvoxamine 50 mg | Weight gain | ||
| M | 18 | – | Congenital hypoparathyroidism, pulmonary artery stenosis, hyperdense foci in frontal lobes, and basal ganglia on cerebral CT | Psychosis | 1 | Quetiapine 800 mg | – | Sedation, weight gain | |||
| 2 | Amisulpride 1,000 mg | – | Unspecified dystonia | ||||||||
| 3 | Olanzapine 30 mg | – | Sedation, weight gain | ||||||||
| Thomas (2003) | Article | M | 23 | ID | – | – | Psychosis | 1 | Risperidone 2 mg | Calcium | Psychomotor retardation |
| Yacoub and Aybar (2007) | Article | F | 25 | Borderline intellectual functioning | – | Prominence of the lateral ventricles | Psychosis | 1 | Clozapine 150 mg | – | Mild sedation, hyper salivation, tonic–clonic seizure |
| 2 | Clozapine 75 mg | Divalproex sodium 750 mg | – | ||||||||
Abbreviations: – = not reported/not present, mg = milligram, F = female, M = male, sz = schizophrenia, ASD = autism spectrum disorder, # = number, NR = not reported, ID = intellectual disability.
a
This case report describes a 2‐year‐old with recurrent pneumonia, a prior seizure, pulmonary hypertension, and right heart failure. The child underwent surgical repair of congenital cardiac defects. Psychiatrists were consulted to assist with managing the delirium while she was intubated and sedated.