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A descriptive study of aripiprazole, brexpiprazole, and cariprazine exposures in children ages 0 to 5 years reported to United States poison centers.
Clin Toxicol (Phila). 2023 02; 61(2):110-115.CT

Abstract

INTRODUCTION

Increased prescribing of antipsychotics and availability of new antipsychotics has resulted in increased exposures in children. Current data on aripiprazole, brexpiprazole, and cariprazine are limited.

METHODS

This was a retrospective database study utilizing the National Poison Data System from 2015 through 2021. We included cases of single substance exposures to aripiprazole, brexpiprazole, cariprazine, or lumateperone in children ages 0 to 5 years old with follow-up to a known outcome. Key outcomes were medical outcomes, clinical effects, and level of care if treated in a healthcare facility.

RESULTS

There were 3,573 aripiprazole, 137 brexpiprazole, 249 cariprazine, and one lumateperone exposure over the period. Primary outcomes were evaluated in 2,655 cases (2,390 aripiprazole, 96 brexpiprazole, and 169 cariprazine). Fifty-one percent were male and 77% were between 0 and 2 years old. Moderate effect was coded in 16.6% of aripiprazole, 23% of brexpiprazole, and 12% of cariprazine exposures. Major effect was coded in 0.6% of aripiprazole, 1% of brexpiprazole, and 2.4% of cariprazine exposures. Duration of symptoms was mostly between 8 and 24 h for 34.6% of aripiprazole, 30% of brexpiprazole, and 32% of cariprazine exposures. Over 60% of the children seen in a health care facility were discharged from the emergency department. The lowest doses resulting in at least a moderate effect and admission to a health care facility was 0.46 mg/kg for aripiprazole, 2.1 mg/kg for brexpiprazole, and 1.9 mg/kg for cariprazine. Important clinical effects included central nervous system depression, tremors, tachycardia, agitation, and vomiting.

CONCLUSION

Reported ingestions of aripiprazole, brexpiprazole, or cariprazine may result in neurologic symptoms like central nervous system depression or seizures in children. The prolonged duration of symptoms resulted in admission for at least a day for many cases. Further research should address optimal monitoring time and location for these exposures.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Husak N
Department of Pharmacy, Advocate Christ Medical Center, Oak Lawn, IL, USA.
Laudone TW
Deparment of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA. Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA.
Leonard JB
Maryland Poison Center, Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.

MeSH

MaleChildHumansUnited StatesInfant, NewbornInfantChild, PreschoolFemaleAripiprazoleAntipsychotic AgentsPoisonsRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36762866

Citation

Husak, Nicholas, et al. "A Descriptive Study of Aripiprazole, Brexpiprazole, and Cariprazine Exposures in Children Ages 0 to 5 Years Reported to United States Poison Centers." Clinical Toxicology (Philadelphia, Pa.), vol. 61, no. 2, 2023, pp. 110-115.
Husak N, Laudone TW, Leonard JB. A descriptive study of aripiprazole, brexpiprazole, and cariprazine exposures in children ages 0 to 5 years reported to United States poison centers. Clin Toxicol (Phila). 2023;61(2):110-115.
Husak, N., Laudone, T. W., & Leonard, J. B. (2023). A descriptive study of aripiprazole, brexpiprazole, and cariprazine exposures in children ages 0 to 5 years reported to United States poison centers. Clinical Toxicology (Philadelphia, Pa.), 61(2), 110-115. https://doi.org/10.1080/15563650.2022.2163901
Husak N, Laudone TW, Leonard JB. A Descriptive Study of Aripiprazole, Brexpiprazole, and Cariprazine Exposures in Children Ages 0 to 5 Years Reported to United States Poison Centers. Clin Toxicol (Phila). 2023;61(2):110-115. PubMed PMID: 36762866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A descriptive study of aripiprazole, brexpiprazole, and cariprazine exposures in children ages 0 to 5 years reported to United States poison centers. AU - Husak,Nicholas, AU - Laudone,Thomas W, AU - Leonard,James B, Y1 - 2023/02/10/ PY - 2023/2/11/pubmed PY - 2023/3/21/medline PY - 2023/2/10/entrez KW - Aripiprazole KW - CNS/psychological KW - antipsychotic KW - brexpiprazole KW - cariprazine KW - children SP - 110 EP - 115 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 61 IS - 2 N2 - INTRODUCTION: Increased prescribing of antipsychotics and availability of new antipsychotics has resulted in increased exposures in children. Current data on aripiprazole, brexpiprazole, and cariprazine are limited. METHODS: This was a retrospective database study utilizing the National Poison Data System from 2015 through 2021. We included cases of single substance exposures to aripiprazole, brexpiprazole, cariprazine, or lumateperone in children ages 0 to 5 years old with follow-up to a known outcome. Key outcomes were medical outcomes, clinical effects, and level of care if treated in a healthcare facility. RESULTS: There were 3,573 aripiprazole, 137 brexpiprazole, 249 cariprazine, and one lumateperone exposure over the period. Primary outcomes were evaluated in 2,655 cases (2,390 aripiprazole, 96 brexpiprazole, and 169 cariprazine). Fifty-one percent were male and 77% were between 0 and 2 years old. Moderate effect was coded in 16.6% of aripiprazole, 23% of brexpiprazole, and 12% of cariprazine exposures. Major effect was coded in 0.6% of aripiprazole, 1% of brexpiprazole, and 2.4% of cariprazine exposures. Duration of symptoms was mostly between 8 and 24 h for 34.6% of aripiprazole, 30% of brexpiprazole, and 32% of cariprazine exposures. Over 60% of the children seen in a health care facility were discharged from the emergency department. The lowest doses resulting in at least a moderate effect and admission to a health care facility was 0.46 mg/kg for aripiprazole, 2.1 mg/kg for brexpiprazole, and 1.9 mg/kg for cariprazine. Important clinical effects included central nervous system depression, tremors, tachycardia, agitation, and vomiting. CONCLUSION: Reported ingestions of aripiprazole, brexpiprazole, or cariprazine may result in neurologic symptoms like central nervous system depression or seizures in children. The prolonged duration of symptoms resulted in admission for at least a day for many cases. Further research should address optimal monitoring time and location for these exposures. SN - 1556-9519 UR - https://www.unboundmedicine.com/medline/citation/36762866/A_descriptive_study_of_aripiprazole_brexpiprazole_and_cariprazine_exposures_in_children_ages_0_to_5_years_reported_to_United_States_poison_centers_ DB - PRIME DP - Unbound Medicine ER -