Pedal edema associated with atypical antipsychotics

Abstract

This study describes a patient diagnosed as a case of bipolar affective disorder complaining of bothersome incidence of pedal edema 1 month after the initiation of atypical antipsychotic regimen with risperidone and quetiapine. All hematological and biochemical profiles were found to be normal. On discontinuation of risperidone, the condition remained unresolved even after 2 weeks, and the edema progressed reaching her calves. On tapering the dose of quetiapine, she started showing gradual improvement in edematous condition. Quetiapine was slowly discontinued. No further recurrence of edema occurred, and hence, no further medication changes were implemented. Pedal edema was found to be resolved within weeks of dechallenge of the regimen. Naranjo adverse drug reaction probability scale gave a score of 7 which denotes “probable” adverse drug reaction with quetiapine.

Risperidone induced angioedema with concurrent EPS symptoms: a case report and review of literature

“…Risperidone blockade of 5HT2 receptors can potentially increase cyclic adenosine monophosphate, which relaxes vascular smooth muscle and lead to edema [11]. High plasma concentrations of cyclic AMP have been noted in patients with idiopathic edema [11].…”

“…Risperidone blockade of 5HT2 receptors can potentially increase cyclic adenosine monophosphate, which relaxes vascular smooth muscle and lead to edema [11]. High plasma concentrations of cyclic AMP have been noted in patients with idiopathic edema [11]. Second, it is possible that risperidone’s action on muscarinic M1, histamine H1, serotonin HT2 receptors can downregulate the adenosine triphosphate-dependent calcium pump and lead to a secondary reduction in smooth muscle contractility, resulting in vasodilation and edema [11].…”

“…High plasma concentrations of cyclic AMP have been noted in patients with idiopathic edema [11]. Second, it is possible that risperidone’s action on muscarinic M1, histamine H1, serotonin HT2 receptors can downregulate the adenosine triphosphate-dependent calcium pump and lead to a secondary reduction in smooth muscle contractility, resulting in vasodilation and edema [11]. Finally, an immunological mechanism was suggested in the first reported case of risperidone related angioedema by Cooney and Nagy [2].…”

Rapid Onset of Pedal Edema Associated with Risperidone in Two Male Patients: Simultaneous Clinical Cases

“…There have also been case reports of angioneurotic edema due to risperidone and periorbital edema due to long-acting risperidone (7,8). PubMed search with key terms "risperidone" and "pedal edema" revealed only two case reports on risperidone-induced pedal edema (9,10). Here, we present two male patients who developed bilateral pedal edema after treatment with risperidone which resolved spontaneously after stopping risperidone.…”

Antipsychotic Drugs and Peripheral Edema: A Review

“…Sık görülen yan etkileri agranülositoz, miyokardit, siyalore ve kilo alımıdır (21,22). Hem BKAP'lar hem de İKAP'ların bilinen bu yan etkilerinin yanında spesifik olmayan bir diğer istenmeyen yan etkileri periferik ödemdir (23). PubMed, EMBASE, and Google Scholar gibi ortamlarda "antipsikotik" ve "ödem" anahtar kelimeleri ile yapılacak kısa bir araştırma ile oldukça fazla olgu sunumuna ulaşılmaktadır.…”