Pedal edema induced by low-dose risperidone monotheraphy in a child

Bilateral pedal edema associated with lurasidone: a case report

Lurasidone, an atypical antipsychotic, is currently approved for treatment of schizophrenia and bipolar depression. Little is known about whether lurasidone might also cause pedal edema. A 55-year-old female patient had been diagnosed with bipolar I disorder from the age of 26. She had been prescribed escitalopram and quetiapine 300 mg/day for her persistent depressive mood. Later, she took lurasidone plus escitalopram to treat depressive episode. Consequently, she developed mild bilateral swelling over the lower legs and ankles. After lurasidone was discontinued, the bilateral pedal edema was completely resolved, and no further recurrence of edema occurred. Resolution of the edema after discontinuation of lurasidone indicates that the edema may have been caused by lurasidone. Caution should be needed when prescribing lurasidone for patients, as pedal edema may affect patients' adherence to the prescription.

Self-limiting Atypical Antipsychotics-induced Edema: Clinical Cases and Systematic Review

A number of atypical antipsychotics have been associated with peripheral edema. The exact cause is not known. We report two cases of olanzapine-induced edema and a brief review of atypical antipsychotic-induced edema, possible risk factors, etiology, and clinical features. The recommendation is given on different methods of managing this side effect.

Pedal edema associated with atypical antipsychotics

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.

Peripheral Edema Occurring during Treatment with Risperidone Combined with Citalopram

An 80-year-old female presented with symptoms of depression, worthlessness, hopelessness, loss of energy, insomnia, impatience, and forgetfulness associated with persecutory delusion that had begun about one year before her visit. She was diagnosed with major depression with psychotic signs and began treatment with risperidone (2 mg/night) and citalopram (20 mg/day). After 20 days, she returned and reported partial improvement in her symptoms, although she had developed severe swelling of the hands and feet. The results of liver and renal function tests and rheumatologic tests were found to be within normal limits. Risperidone was discontinued for a week, and the swelling resolved completely. Risperidone was then administered again, and the swelling returned so that the patient had to discontinue taking the drug. The reappearance of edema on rechallenge is strong evidence implicating risperidone as the cause of the swelling.