Intentional Coingestion of RisperiDONE and Ethylene Glycol in a 35-Year-Old: A Case Review.

Abstract

This is a complex case of an intentional coingestion involving ethylene glycol, a toxic alcohol, and risperiDONE, an atypical antipsychotic. The patient presented to the emergency department with a myriad of symptoms reflecting the combined toxicities. Ethylene glycol poisoning is characterized by its metabolic conversion to toxic metabolites, leading to severe metabolic acidosis, renal failure, and neurotoxicity. The coingestion of risperiDONE, although less immediately life-threatening, complicates the clinical picture. RisperiDONE is a central nervous system depressant that may contribute to ethylene glycol's neurologic derangements. RisperiDONE has a potential for cardiac complications by prolonging the QT interval reflected in the electrocardiogram. This combination of ingestions can lead to potential lethal cardiac dysrhythmias. This patient presentation highlights the challenges in the diagnosis and management of this combination of overdoses, necessitating a high index of suspicion, rapid identification of the ingested toxins, and aggressive supportive care. This case review underscores the importance of considering the synergistic effects of these 2 coingested substances, which can significantly alter the expected clinical course and prognosis.