A case-control study of neuroleptic malignant syndrome

Neuroleptic malignant syndrome developing after acute overdose with olanzapine and chlorpromazine

“…Symptoms commonly resolve over hours to days depending on the size of the overdose and do not usually result in any long-term sequelae. Once the acute sedative toxicity resolved in our patient, the clinical features that developed subsequently satisfied the diagnostic criteria for NMS established by DSM-IV and several other authors [14,15]. She took her neuroleptic overdose after a break of several weeks with the addition of a small amount of a second agent.…”

Psychotropic discontinuation leading to an NMS‐like condition

“…This case could be described as atypical NMS as the patient had most of the core criteria of NMS other than extrapyramidal symptoms. However, he fulfils the criteria for NMS as described by Sachdev et al 11 and Levenson. 12 With regard to the differential diagnosis, although the patient had restlessness and agitation, he did not have other symptoms of cholinergic rebound such as nausea, vomiting, abdominal cramps, diarrhoea, headache, sweating and urinar y urgency, and hence we discounted the possibility of cholinergic rebound syndrome.…”

“…10 General diagnostic criteria for NMS include extrapyramidal symptoms, hyperpyrexia, clouding of consciousness and autonomic abnormalities together with biochemical abnormalities. [11][12][13][14] However, there are several case reports in which patients have not presented with all the core symptoms, leading to such cases being termed 'atypical NMS'. The diagnosis and the uncertainly of the nature and course of this condition have been discussed by Picard et al, 15 Odagaki 16 and Trollor et al 17 Our patient had altered consciousness, fever, sweating, elevated CPK and WBC, tachycardia, tachypnoea and incontinence but no documented reports of rigidity, as this was not checked due to his aggression.…”

The Kahlbaum Syndrome is a Risk Factor for the Development of Neuroleptic Malignant Syndrome

“…Higher dose, rapid rate of dose increase and parenteral administration of antipsychotics have been defi ned as potential risk factors for NMS [3][4][5]. However, information regarding the clinical risk factors is much more limited, and no specifi c psychiatric diagnosis predisposing to the syndrome has been reported.…”

“…Neuroleptic malignant syndrome (NMS) is a life-threatening adverse event associated with antipsychotic therapy, and continues to be reported even with new antipsychotics [1][2][3]. Higher dose, rapid rate of dose increase and parenteral administration of antipsychotics have been defi ned as potential risk factors for NMS [3][4][5].…”