{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:31:21Z","timestamp":1788435081131,"version":"build-2803163510"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,22]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Risperidone and aripiprazole are increasingly used for behavioural indications in children and adolescents with intellectual disabilities, including autism. Although there are some reports in literature, the side effect profile in this population remains poorly defined and there is a need to raise awareness among clinicians across specialties. We present two patients with significant intellectual disabilities who developed extrapyramidal side effects (EPSE) including oculogyric crisis following risperidone and aripiprazole use. The onset of these side effects can be insidious and the non-specific nature of the presentation, for example, poor mobility and increased drooling on a background of severe intellectual disability, can lend itself to delay in recognition and reporting by families. There is also reduced awareness among paediatricians, which can further delay the treatment of this reversible condition. There needs to be ongoing vigilance for EPSE as they can develop years after treatment has been initiated.<\/jats:p>","DOI":"10.1136\/bcr-2022-251974","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T11:00:49Z","timestamp":1672830049000},"page":"e251974","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Recognising side effects of antipsychotics in children with intellectual disabilities"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5152-5822","authenticated-orcid":false,"given":"Jessica","family":"Lee","sequence":"first","affiliation":[{"name":"Acute Paediatrics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Shepperd","sequence":"additional","affiliation":[{"name":"Child and Adolescent Mental Health Services Learning Disability Team, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Smith","sequence":"additional","affiliation":[{"name":"Paediatric Neurology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetha","family":"Anand","sequence":"additional","affiliation":[{"name":"Acute Paediatrics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"2025082803394032000_16.1.e251974.1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.164.2.141"},{"key":"2025082803394032000_16.1.e251974.2","unstructured":"Learning disabilities and behaviour that challenges overview. NICE clinical guideline. NICE pathways. Available: https:\/\/pathways.nice.org.uk\/pathways\/learning-disabilities-and-behaviour-that-challenges [Accessed 04 Aug 2021]."},{"key":"2025082803394032000_16.1.e251974.3","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.4.677"},{"key":"2025082803394032000_16.1.e251974.4","doi-asserted-by":"crossref","first-page":"285","DOI":"10.9758\/cpn.2017.15.3.285","article-title":"Aripiprazole-induced tardive dyskinesia in 13 years old girl successfully treated with biperiden: a case report","volume":"15","author":"Lamberti","year":"2017","journal-title":"Clin Psychopharmacol Neurosci"},{"key":"2025082803394032000_16.1.e251974.5","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/13668250903070891","article-title":"Extrapyramidal symptoms and medication use in mucopolysaccharidosis type III","volume":"34","author":"Tchan","year":"2009","journal-title":"J Intellect Dev Disabil"},{"key":"2025082803394032000_16.1.e251974.6","first-page":"499","article-title":"Oculogyric crisis with atypical antipsychotics: a case series","volume":"59","author":"Nebhinani","year":"2017","journal-title":"Indian J Psychiatry"},{"key":"2025082803394032000_16.1.e251974.7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2003.00205.x"},{"key":"2025082803394032000_16.1.e251974.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-006-0504-0"},{"key":"2025082803394032000_16.1.e251974.9","doi-asserted-by":"publisher","DOI":"10.2165\/00128072-200103120-00005"},{"key":"2025082803394032000_16.1.e251974.10","doi-asserted-by":"publisher","DOI":"10.1177\/106002809603000407"},{"key":"2025082803394032000_16.1.e251974.11","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.rpsm.2012.03.006","article-title":"Efectos secundarios del tratamiento antipsic\u00f3tico en ni\u00f1os Y adolescentes na\u00efve O quasi-na\u00efve: dise\u00f1o de un protocolo de seguimiento Y resultados basales","volume":"5","author":"Merch\u00e1n-Naranjo","year":"2012","journal-title":"Revista de Psiquiatr\u00eda y Salud Mental"},{"key":"2025082803394032000_16.1.e251974.12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1268"},{"key":"2025082803394032000_16.1.e251974.13","first-page":"214","article-title":"Low-Dose risperidone-induced oculogyric crises in an adolescent male with autism, Tourette's and developmental delay","volume":"20","author":"Masliyah","year":"2011","journal-title":"J Can Acad Child Adolesc Psychiatry"},{"key":"2025082803394032000_16.1.e251974.14","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4103\/0976-500X.99446","article-title":"Aripiprazole-induced oculogyric crisis (acute dystonia)","volume":"3","author":"Bhachech","year":"2012","journal-title":"J Pharmacol Pharmacother"},{"key":"2025082803394032000_16.1.e251974.15","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2217\/17410541.5.4.361","article-title":"Pharmacogenetic testing of CYP2D6 in patients with aripiprazole-related extrapyramidal symptoms: a case-control study","volume":"5","author":"Subuh Surja","year":"2008","journal-title":"Per Med"},{"key":"2025082803394032000_16.1.e251974.16","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/tpj.2016.44","article-title":"Pharmacogenetic study of antipsychotic induced acute extrapyramidal symptoms in a first episode psychosis cohort: role of dopamine, serotonin and glutamate candidate genes","volume":"16","author":"Mas","year":"2016","journal-title":"Pharmacogenomics J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:39:49Z","timestamp":1756377589000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,4]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/bcr-2022-251974"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251974","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}