Risperidone Associated Paralytic Ileus in Schizophrenia
A 32-year-old, male with no medical comorbidities was showing symptoms of schizophrenia for past 8 months and then catatonic symptoms for past 1 month for which he was admitted to psychiatry ward for evaluation. He was treated with lorazepam orally (2-4 mg/day) for resolution of catatonia and risperidone 4 mg/day for his underlying psychotic illness. He remained on nasogastric tube (NT) feed along with input, output and vital monitoring. On the 8th day of starting treatment he developed bloating of abdomen, followed by vomiting. The consultation was sought from surgical speciality and he was diagnosed with paralytic ileus and managed conservatively and risperidone was stopped. He was continued on lorazepam at same dose as he had shown partial response in catatonia symptom resolution. His abdominal condition improved over 3 days and his NT feed was resumed and for his rapid resolution of catatonic symptoms he was advised to undergo ECT.