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Possible Paliperidone-Related Pons Infarction
Cheng-Chen Chang; Wen-Fang Wang; Te-Jen Lai, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E15-E16. doi:10.1176/appi.neuropsych.13010001
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All authors declared no conflict of interest in the case report.

Dept. of Psychiatry
Changhua Christian Hospital
Institute of Medicine, Chung Shan Medical University Taiwan

School of Nursing, China Medical University

Dept. of Psychiatry
Chung Shan Medical University Hospital
Taichung, Taiwan

Correspondence: Dr. Chang; e-mail: 55810@cch.org.tw

Copyright © 2014 by the American Psychiatric Association


To the Editors: Risperidone-treated patients with dementia experienced more strokes and transient ischemic attacks than did placebo-treated patients.1 Paliperidone (9-hydroxy- risperidone) is the principal active metabolite of risperidone. Whether paliperidone increases the risk of cerebrovascular adverse events (CVAEs) in patients with schizophrenia is unknown. Here, we report on a schizophrenia patient with hypertension and hyperlipidemia who developed a pons infarction shortly after receiving paliperidone.

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Important Drug Safety Information:  RISPERDAL (risperidone) and Cerebrovascular Adverse Events in Placebo-Controlled Dementia Trials.  Janssen-Ortho Inc.; available at http://www.hc-sc.gc.ca/hpfb-dgpsa/tpd-dpt/risperdale.html; 2003
Sacchetti  E;  Turrina  C;  Cesana  B  et al:  Timing of stroke in elderly people exposed to typical and atypical antipsychotics: a replication cohort study after the paper of Kleijer, et al.  J Psychopharmacol 2010; 24:1131–1132
[CrossRef] | [PubMed]
Kleijer  BC;  van Marum  RJ;  Egberts  AC  et al:  Risk of cerebrovascular events in elderly users of antipsychotics.  J Psychopharmacol 2009; 23:909–914
[CrossRef] | [PubMed]
Smith  DA;  Beier  MT:  Association between risperidone treatment and cerebrovascular adverse events: examining the evidence and postulating hypotheses for an underlying mechanism.  J Am Med Dir Assoc 2004; 5:129–132
[CrossRef] | [PubMed]
Huybrechts  KF;  Schneeweiss  S;  Gerhard  T  et al:  Comparative safety of antipsychotic medications in nursing home residents.  J Am Geriatr Soc 2012; 60:420–429
[CrossRef] | [PubMed]
Wallaschofski  H;  Donné  M;  Eigenthaler  M  et al:  PRL as a novel potent cofactor for platelet aggregation.  J Clin Endocrinol Metab 2001; 86:5912–5919
[CrossRef] | [PubMed]
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Possible paliperidone-related pons infarction. J Neuropsychiatry Clin Neurosci 2014;26(1):E15-6.