Phenothiazine, Butyrophenone, and Other Psychotropic Medication Poisonings in Children and Adolescents

James, Laura P.; Abel, Ki L.; Wilkinson, Joshua Marie; Simpson, Pippa; Nichols, Michele

doi:10.1081/clt-100102010

Cited by 19 publications

(10 citation statements)

References 28 publications

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“…These studies were from Italy, [4][5][6] the United Kingdom, 7 and the United States. 8 The US study was found to be a case series concerned with phenothiazine and butyrophenone poisonings. A large number of additional pharmacoepidemiologic studies from the United States and other countries were identified through the scanning of reference lists, including 2 reviews identified in the search.…”

Section: Methodsmentioning

confidence: 99%

A Review of Pharmacoepidemiologic Studies of Antipsychotic Use in Children and Adolescents

2012

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Objective: In Canada, treatment of children and adolescents with antipsychotics is almost always off label. A single atypical agent, aripiprazole, only recently received regulatory authorization for use in the group aged 15 to 17 years. This regulatory approval was restricted to treatment of schizophrenia. The objective of this review was to summarize pharmacoepidemiologic reports examining the frequency of use of these medications. Methods:A literature search was used to identify English-language studies examining the pharmacoepidemiology of antipsychotics in children and adolescents. The results of identified studies were summarized using narrative review methods. Results:In countries where longitudinal data are available, increased antipsychotic use has been consistently observed. Generally, most or all of this increase can be attributed to second-generation antipsychotics (SGAs). Major international differences are evident in the literature. European studies describe lower overall frequencies of use than North American studies (most of which were conducted in the United States). SGAs in children and adolescents are used more often in boys than in girls, and are increasingly used for treatment of attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD). Conclusions:Determining the most appropriate frequency of SGA use in children and adolescents will ultimately depend on decisive clarification of risks and benefits. The currently available literature highlights large international differences in the frequency of use. These differences may reflect fundamental dissimilarities in the therapeutic stance adopted toward ADHD and CD by physicians practicing in different countries. W W WObjectif : Au Canada, le traitement des enfants et des adolescents par antipsychotiques est presque toujours non indiqué sur l'étiquette. Un seul agent atypique, l'aripiprazole, a reçu récemment l'autorisation réglementaire d'utilisation auprès du groupe des 15 à 17 ans. Cette approbation réglementaire se limitait au traitement de la schizophrénie. L'objectif de cette revue était de résumer les études pharmaco-épidémiologiques qui examinent la fréquence d'utilisation de ces médicaments.Méthodes : Une recherche de la littérature a servi à identifier les études en anglais qui examinent la pharmaco-épidémiologie des antipsychotiques chez les enfants et les adolescents. Les résultats des études identifiées ont été résumés à l'aide de méthodes de revue narrative. Résultats :Dans les pays qui disposent de données longitudinales, une utilisation accrue des antipsychotiques a été observée régulièrement. Généralement, une grande partie ou la totalité de cet accroissement peut être attribuée aux antipsychotiques de deuxième génération (ADG). Des différences majeures entre les pays sont manifestes dans la littérature. Les études européennes décrivent des fréquences d'utilisation globalement plus faibles que les études nord-américaines (dont la plupart ont été menées aux États-Unis). Les ADG chez les enfants et les adolescents so...

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Section: Methodsmentioning

confidence: 99%

A Review of Pharmacoepidemiologic Studies of Antipsychotic Use in Children and Adolescents

2012

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“…[1][2][3][4][5][6][7][8][9][10] In developing countries, poisoning has also been recognised as a major health problem among children and adolescents. [11][12][13] Ahmed and Andersson compared the mortality rates of unintentional injuries, including poisoning, in countries with different income levels, and found that poisoning is the second most common cause of death in all lower and upper middle income countries among the [15][16][17][18][19][20][21][22][23][24] year age group. 12 Certain poison types of medicinal and non-medicinal substances have been identified as common agents in poisoning in children and adolescents.…”

mentioning

confidence: 99%

“…12 Certain poison types of medicinal and non-medicinal substances have been identified as common agents in poisoning in children and adolescents. [14][15][16][17] Riordan et al reviewed the literature on childhood poisoning and identified several groups of medicinal substances as the most common. 14 15 These included analgesics, anti-inflammatory agents, psychotropic drugs such as antidepressants, and benzodiazepines related agents.…”

mentioning

confidence: 99%

Childhood and adolescence poisoning in NSW, Australia: an analysis of age, sex, geographic, and poison types

Lam

2003

Inj Prev

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Objective: This study aims to investigate whether there is any association between the types of poison substances and geographic locations for different age groups and sex. Design: This is a population based epidemiological study utilising routinely collected inpatient statistics. Setting: Data are collected as part of the routine vital health information system via all hospitals in New South Wales (NSW), Australia. Patients: All patients aged between 0-19 years who were admitted to a hospital because of poisoning by the four major types of substances that were defined in the study in NSW in 2000. Main results: The standardised incidence ratios of poisoning related hospitalisation between metropolitan and rural areas varied across different poison types when compared with the NSW average. While there are few differences between metropolitan and rural areas for analgesic and chemical related poisoning admissions across different age groups and sex, differences in the standardised incidence ratios between geographic locations for psychotropic and venom related poisoning admissions were found. No significant difference in standardised mortality ratios were found between metropolitan and rural areas except for females in the 10-14 years age group (standardised mortality ratio 3.24, 95% confidence interval 1.69 to 6.21). Conclusions:The results obtained in this study, on the whole, provide some evidence for an association between poison types and geographic locations for psychotropic and venom related poisoning. P oisoning has been identified as one of the major causes of childhood and adolescence hospital emergency presentations and admissions in most developed countries including the United States, United Kingdom, and Australia.

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“…Although the great majority of reported cases of pediatric toxicity from phenothiazines result from chlorpromazine, James et al reported a 19-month-old who developed altered mental status (Glasgow Coma Scale score of 9) and a prolonged QTc after ingesting 38 mg/kg of thioridazine (48). The highest dose thioridazine tablet available is 200 mg, thus, a 10-kg child could ingest this amount with just two pills.…”

Section: Literature Reviewmentioning

confidence: 98%

Are one or two dangerous? Phenothiazine exposure in toddlers

Love

Smith

Simmons

2006

The Journal of Emergency Medicine

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Phenothiazine, Butyrophenone, and Other Psychotropic Medication Poisonings in Children and Adolescents

Cited by 19 publications

References 28 publications

A Review of Pharmacoepidemiologic Studies of Antipsychotic Use in Children and Adolescents

A Review of Pharmacoepidemiologic Studies of Antipsychotic Use in Children and Adolescents

Childhood and adolescence poisoning in NSW, Australia: an analysis of age, sex, geographic, and poison types

Are one or two dangerous? Phenothiazine exposure in toddlers

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