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{
    "pk": 1123,
    "title": "Abilifright: A Case Report of Massive Aripiprazole Overdose in a Toddler",
    "subtitle": null,
    "abstract": "Introduction\n: Aripiprazole is an atypical antipsychotic with unique receptor-binding properties that has a favorable safety profile in therapeutic doses compared to other antipsychotics. Massive aripiprazole overdose in children, however, presents with profound lethargy and may have neurologic, hemodynamic, and cardiac effects, often requiring admission to a high level of care.\nCase Report:\n We describe a case of a 21-month-old male with a reported 52-milligram aripiprazole ingestion. Initial vital signs were remarkable for tachycardia and hypertension, which rapidly resolved. The patient did not develop hypotension throughout hospitalization. He experienced 60 hours of lethargy. Irritability associated with upper extremity spasms and tremors occurred from 36-72 hours post ingestion, which resolved without intervention. The initial electrocardiogram demonstrated ST-segment depressions in the anteroseptal leads; further cardiac workup was normal. Concurrent medical workup was unrevealing. Aripiprazole and dehydro-aripiprazole serum concentrations sent 46 hours after reported exposure were 266.5 nanograms per milliliter (ng/mL) and 138.6 ng/mL, respectively. He returned to neurologic baseline and was discharged 72 hours after ingestion.\nConclusion:\n Antipsychotics, including aripiprazole, should be considered as a potential toxicological cause of persistent central nervous system depression; ingestion of a single dose has the potential to cause significant toxicity.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "atypical antipsychotic"
        },
        {
            "word": "aripiprazole"
        },
        {
            "word": "overdose"
        },
        {
            "word": "pediatrics"
        },
        {
            "word": "toxicology"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6gx0c5n6",
    "frozenauthors": [
        {
            "first_name": "Nicholus",
            "middle_name": "",
            "last_name": "Warstadt",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Sanjay",
            "middle_name": "",
            "last_name": "Mohan",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, Division of Medical Toxicology, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Emma",
            "middle_name": "",
            "last_name": "Furlano",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, Division of Medical Toxicology, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Jennifer",
            "middle_name": "",
            "last_name": "Shenker",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Department of Pediatrics, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Eric",
            "middle_name": "",
            "last_name": "Gibbs",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Department of Pediatrics, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Silas",
            "middle_name": "",
            "last_name": "Smith",
            "name_suffix": "",
            "institution": "New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, Division of Medical Toxicology, New York, New York; New York University Grossman School of Medicine, Institute for Innovations in Medical Education, New York, New York",
            "department": "None"
        }
    ],
    "date_submitted": "2022-01-28T20:22:06-08:00",
    "date_accepted": "2022-01-28T20:22:06-08:00",
    "date_published": "2022-01-28T20:23:22-08:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1123/galley/863/download/"
        }
    ]
}