{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:00:49Z","timestamp":1762999249314,"version":"3.41.0"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T00:00:00Z","timestamp":1492992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Cases<\/jats:title><jats:p>Case 1: A 20\u2010year\u2010old woman suffering a suspected overdose was transported to the hospital. She presented bradycardia with wide<jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content>waves and<jats:styled-content style=\"fixed-case\">QT<\/jats:styled-content>prolongation, followed by cardiac arrest. Extracorporeal cardiopulmonary resuscitation was implemented, improving circulation. Risperidone and 9<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">RIS<\/jats:styled-content>levels were 9.6 ng\/mL and 127.6 ng\/mL, respectively. Case 2: A 54\u2010year\u2010old woman was hospitalized for femoral fracture and underwent surgery. Her electrocardiogram showed bradycardia and complete<jats:styled-content style=\"fixed-case\">AV<\/jats:styled-content>block. Risperidone and 9<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">RIS<\/jats:styled-content>levels were 3.2 ng\/mL and 61.4 ng\/mL, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome<\/jats:title><jats:p>In both cases, only serum concentration of 90H\u2010RIS were elevated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Arrhythmia related to risperidone has proven rare but sometimes fatal. Serum concentrations of risperidone and the metabolite 9\u2010hydroxy\u2010risperidone (9OH\u2010RIS) during these events are seldom documented. As 9<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">RIS<\/jats:styled-content>shows pharmacological activity equivalent to risperidone, it may induce life\u2010threatening arrhythmia (regardless of the intake dosage). It is critical to evaluate the serum concentration of 9<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">RIS<\/jats:styled-content>in suspected risperidone toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.277","type":"journal-article","created":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T11:29:36Z","timestamp":1493033376000},"page":"341-343","source":"Crossref","is-referenced-by-count":7,"title":["Two cases of life\u2010threatening arrhythmia induced by risperidone: evaluation of risperidone and 9\u2010hydroxy\u2010risperidone concentrations"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2086-4231","authenticated-orcid":false,"given":"Asami","family":"Ito","sequence":"first","affiliation":[{"name":"Emergency and Critical Care Center Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Enokiya","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Iwashita","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taichi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ikemura","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Okuda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Imai","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center Mie University Hospital Tsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,24]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"FD Public Health Advisory: Deaths with antipsychotics in elderly patients with behavioral disturbances. 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