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EPISTAXIS AS A RARE SIDE EFFECT OF RISPERIDONE ENCOUNTERED IN A PATIENT WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER; A CASE REPORT

Loloah Mohammad AlAmer , Ali Abdullah Sulais, Muath Khalid AlOmaireen , Abdullah Ahmad AlMulhim

Risperidone is an atypical antipsychotic drug that works as an antagonist of multiple neurotransmitters; mainly serotonin and dopamine. It is used for a wide range of indications. One of the diseases that risperidone is used for is Attention deficit hyperactivity disorder (ADHD), a psychiatric condition usually affects children. Risperidone is generally considered as a safe drug that might have some gastrointestinal, neurological and metabolic side effects. Although thrombocytopenia is a recognized side effect of risperidone; abnormal bleeding in the background of normal platelet count is very uncommon. In the present case, we report the incidence of a rare side effect of risperidone that is seldomly reported in literature; which is epistaxis or nose bleed. This adverse event occurred in an 18-your-old male, known to have ADHD and intellectual disability. He was started on risperidone 2mg tablet once daily for having an exacerbation of his condition. Thirty minutes after taking the first dose, he had profuse bleeding from the nose. This was not associated with any evidence from history, physical examination or labs suggesting other explanations. Very few related cases were reported; with similar presentation and circumstances. In this report, along with presenting our case, we discuss the possible explanations for epistaxis related to risperidone use. Key words: risperidone, epistaxis, attention deficit hyperactivity disorder, psychopharmacology.

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