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Sir: Although factors influencing adherence often overlap, it is possible to differentiate between factors that are related to the patient, the patient’s environment, the treating clinician, and treatment itself. This differentiation may aid the practicing clinician in assessing the various reasons why a particular patient is likely to develop adherence problems. For example, there is a positive correlation between adherence and the patients’ feelings of a positive effect of the drug on the illness. On the other hand, weight gain has a strong impact on quality of life, and therefore probably on adherence. Especially in children and adolescents, overweight due to second-generation antipsychotics (SGAs) might be even more pronounced compared to adults. SGAs are increasingly prescribed for children and adolescents with neuropsychiatric disorders. Although their specific serotonin and dopamine receptor antagonism offers certain advantages compared to typical antipsychotics, their use has been associated with various adverse effects. Most of these drugs are still prescribed in off-label use, and little is known of drug-associated adverse events in pediatric patients, especially in long-term use. In our study, we investigate adherence in children and adolescents and its relationship to various potential risk factors (age, gender, time since discharge, weight gain, and pharmacologic treatment).

Risperidone-Induced Tardive Pharyngeal Dystonia Presenting With Persistent Dysphagia