Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention

Long-acting injectable antipsychotics provide the delivery of medication over an extended period of time requiring administration typically only every 2 to 4 weeks. The side effect profile of a long-acting injectable antipsychotic is predictable and similar to the oral formulation. However, injectio...

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Main Authors: Jonathan G. Leung, Kirstin J. Kooda, Erin N. Frazee, Sarah Nelson, Katherine M. Moore
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2015/364325
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author Jonathan G. Leung
Kirstin J. Kooda
Erin N. Frazee
Sarah Nelson
Katherine M. Moore
author_facet Jonathan G. Leung
Kirstin J. Kooda
Erin N. Frazee
Sarah Nelson
Katherine M. Moore
author_sort Jonathan G. Leung
collection DOAJ
description Long-acting injectable antipsychotics provide the delivery of medication over an extended period of time requiring administration typically only every 2 to 4 weeks. The side effect profile of a long-acting injectable antipsychotic is predictable and similar to the oral formulation. However, injection site reactions may occur with this novel delivery system. The risk of an injection site reaction may be greater with the repeated administration of a lipophilic decanoate formulation and include pain, development of indurations, and fibrosis. Severe complications from injection site reactions have rarely been described in the literature with newer agents. We report the first case of a patient prescribed paliperidone palmitate every 3 weeks that developed severe sepsis requiring vasopressors and intubation due to delayed relayed recognition of a necrotizing infection at an injection site. Clinicians should be alerted to screen for injection site reactions when there is an unknown source infection in a patient receiving a long-acting injectable antipsychotic.
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spelling doaj-art-8a62e961279142cd9afc407dfd032b972025-08-20T02:09:20ZengWileyCase Reports in Psychiatry2090-682X2090-68382015-01-01201510.1155/2015/364325364325Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical InterventionJonathan G. Leung0Kirstin J. Kooda1Erin N. Frazee2Sarah Nelson3Katherine M. Moore4Department of Pharmacy, Mayo Clinic, Rochester, MN 55902, USADepartment of Pharmacy, Mayo Clinic, Rochester, MN 55902, USADepartment of Pharmacy, Mayo Clinic, Rochester, MN 55902, USADepartment of Pharmacy, Mayo Clinic, Rochester, MN 55902, USADepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55902, USALong-acting injectable antipsychotics provide the delivery of medication over an extended period of time requiring administration typically only every 2 to 4 weeks. The side effect profile of a long-acting injectable antipsychotic is predictable and similar to the oral formulation. However, injection site reactions may occur with this novel delivery system. The risk of an injection site reaction may be greater with the repeated administration of a lipophilic decanoate formulation and include pain, development of indurations, and fibrosis. Severe complications from injection site reactions have rarely been described in the literature with newer agents. We report the first case of a patient prescribed paliperidone palmitate every 3 weeks that developed severe sepsis requiring vasopressors and intubation due to delayed relayed recognition of a necrotizing infection at an injection site. Clinicians should be alerted to screen for injection site reactions when there is an unknown source infection in a patient receiving a long-acting injectable antipsychotic.http://dx.doi.org/10.1155/2015/364325
spellingShingle Jonathan G. Leung
Kirstin J. Kooda
Erin N. Frazee
Sarah Nelson
Katherine M. Moore
Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
Case Reports in Psychiatry
title Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
title_full Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
title_fullStr Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
title_full_unstemmed Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
title_short Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention
title_sort paliperidone palmitate associated with necrotizing deep tissue infection and sepsis requiring surgical intervention
url http://dx.doi.org/10.1155/2015/364325
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