P-294 - Oculogyric crisis - unexpected side effect when using low doses of risperidone in adolescent patient

Abstract

The use of antipsychotics in treatment of children and adolescents requires good knowledge of psychopathology, psychofarmacotherapy, developmental processes and family relations. The combination of clinical experience of those working with psychotic adolescents and a good collaboration with parents, creates a therapeutic space where good results in treatment can be achieved. The number of antipsychotics registered for use in children and adolescents is quite limited. It is necessary to have parental consent for the use of a medication in this age, with previous explanation of therapeutic goals, limitations and possible side effects of antipsychotics. We present a 14-year old girl adolescent with psychotic symptoms, in which case the course of treatment and discontinuance of therapy was caused by a side effect - an oculogyric crisis. In the treatment we used a low daily dose of risperidone, a generic medication (1 mg) per os, in the evening. We used generic, not an original medication, respecting recommendations of health sector economy. The effect of the terapy was measured using Clinical Global Impression Scale (CGI) and Brief Psychiatric Rating Scale (BPRS). The daily dose of risperidone wasn‘t elevated. The girl was discharged six days after risperidone was first prescribed. Side effects were not expected. On the way home, the patient experiences oculogyric crisis. Our clinical presentation indicates that, in spite of low doses of risperidone in generic form, side effects are not excluded, and that wasn‘t noticed when original antipsychotics were used in the same doses.