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PAradoxical Reaction to Zxprexa Zydis?

Have any of you seen a patient have a paradoxical rx to ZZ?

I gave ZZ 10mg p.o. to a defiant, disobediant and disruptive patient, per M.D. order. First of all, why is ZZ given to this type of patient, who is NOT, by the way, psychotic, just kind of bratty. Secondly, after he took it, he was jumpy, irritable, still disobediant and not in the least bit calm. I got a new order for Benadryl 50 mg P.o. or I.M., he took it P.o. and it took awhile but it finally sedated him.

Thunderwolf, MSN, RN

Has 32 years experience. Specializes in Med-Surg, Geriatric, Behavioral Health.

Antipsychotics are used for acute/severe aggitation, not only for psychosis. ZZ disolves quickly, reducing the need for a mouth check. I would imagine that the combination of both ZZ and the Benadryl helped reduce your patient's aggitation...as well as the other interventions that you might have used until the meds kicked in.

Good question.

so they decided to fight the snake instead of riding it?

I don't understand what you mean.

Have any of you seen a patient have a paradoxical rx to ZZ?

I gave ZZ 10mg p.o. to a defiant, disobediant and disruptive patient, per M.D. order. First of all, why is ZZ given to this type of patient, who is NOT, by the way, psychotic, just kind of bratty. Secondly, after he took it, he was jumpy, irritable, still disobediant and not in the least bit calm. I got a new order for Benadryl 50 mg P.o. or I.M., he took it P.o. and it took awhile but it finally sedated him.

In my experience any antipsychotic can cause a motor restlessnes and agitation caused by a side effect called akisthisia. More common with the older antipsychotics, it can be treated with klonopin, benadryl or cogentin. I also wonder if the kid was on any other meds or using any drugs.

Thunderwolf, MSN, RN

Has 32 years experience. Specializes in Med-Surg, Geriatric, Behavioral Health.

In my experience any antipsychotic can cause a motor restlessnes and agitation caused by a side effect called akisthisia. More common with the older antipsychotics, it can be treated with klonopin, benadryl or cogentin. I also wonder if the kid was on any other meds or using any drugs.

Yes, definitely something to consider.

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