"Brief" Aripiprazole-induced Neuroleptic Malignant Syndrome with Symptoms that Only Lasted a Few Hours

Mizumura, Naoto; Uematsu, Masato; Ito, Aya; Okumura, Satoshi; Maehira, Hiromitsu; Ogawa, Masao; Kawasaki, Masayasu

doi:10.2169/internalmedicine.9037-17

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…The first noted NMS with Aripiprazolum was to our best account reported in 2004 (11) with few others to follow with atypical presentation (12,13). Our case resembled one reported by Mizumura et all with low blood serum iron concentration and symptoms which lasted only a few hours (14). Finally, a case of tardive diskinesia worsening with Aripiprazolum was reported in 2009 in a patient with DLB which was previously treated with Risperidonum (15).…”

Section: Discussionsupporting

confidence: 72%

"Differential diagnosis between Pick’s Dementia and Dementia with Lewy body deciphered by the development of neuroleptic malignant syndrome: a case report"

Iacob¹,

Palimariciuc²,

Chiriță³

et al. 2020

BPI

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Dementia with Lewy bodies (DLB) and Pick's Dementia (PD) share some of the signs and symptoms of Alzheimer's disease (AD) but are clinically distinct entities. The first one is differentiated through the manifestation of hallucinations and Parkinsonism while the second one's particularity are the behavioural symptoms preceding the cognitive deficit. This paper features a case of a patient, which initially manifested symptoms specific to PD, but developed Neuroleptic Malignant Syndrome (NMS) while under treatment with an atypical antipsychotic, which led to a presumed diagnosis of DLB although initially, the patient manifested none of the core symptoms for DLB.

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Section: Discussionsupporting

confidence: 72%

"Differential diagnosis between Pick’s Dementia and Dementia with Lewy body deciphered by the development of neuroleptic malignant syndrome: a case report"

Iacob¹,

Palimariciuc²,

Chiriță³

et al. 2020

BPI

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“…It is unknown whether this is a precipitating factor for the development of NMS or a result of the syndrome itself 2,5 . There are also confounding variables in the description of aripiprazole induced NMS, as it can be controversially described as “atypical NMS.” 19,21 This presentation of NMS not meeting all classically associated criteria may be what contributed to the delay in diagnosis and the normal creatine kinase level in our patient's case. The other unknown factor is lithium's mechanism of action, but it is theorized that it has effects on the dopaminergic pathway by inhibiting glycogen synthase kinase 3 3,14…”

Section: Resultsmentioning

confidence: 88%

A Case of Neuroleptic Malignant Syndrome in the Context of Lithium Toxicity and Aripiprazole Use

Schultz,

Singh,

Linek-Rajapaksha

et al. 2023

Clin Neuropharm

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Objective Neuroleptic malignant syndrome (NMS) is a rare life-threatening condition that providers should be cognizant of when prescribing dopamine-receptor antagonists. Atypical antipsychotic agents were initially considered to have a lower risk of inducing the development of NMS compared with conventional antipsychotic. Considerable evidence, however, has suggested that atypical antipsychotics are associated with NMS, including the partial dopamine agonist, aripiprazole. There is growing evidence that other psychotropics, including lithium, cause this condition. Here, the authors present a case of a patient who developed NMS from lithium and aripiprazole and provide a literature review of reported NMS cases with either psychotropic. Method and Results The authors report the case of 60-year-old male patient who developed NMS over a hospital course during which both aripiprazole and lithium were prescribed. In addition, a literature review was performed and a summary of cases of NMS induced by either lithium and/or aripiprazole is provided. Conclusions This case adds to the growing body of literature of aripiprazole and lithium-induced NMS. Only 2 other cases are reported where concomitant aripiprazole and lithium use lead to NMS. Interestingly, our patient did develop lithium toxicity during hospitalization, but the NMS diagnosis occurred after lithium toxicity resolved. This varies from the other 2 cases where NMS developed despite lithium levels always being therapeutic. Unfortunately, there are more questions than answers surrounding this rare complication involving these 2 psychotropics and clinical vigilance is warranted when using these psychotropics especially in cases where aripiprazole and lithium are used in combination.

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“…They could be classified into two groups: (1) cases in which NMS onset was triggered by administering causative drugs 17–19,22–89 and (2) cases in which NMS developed from disruption of regular medication (Tables 7 and 8). 8,16,90–114 An example of the former is a case in which antipsychotic drugs were administered for postoperative delirium; an example of the latter is a case in which regular medication (i.e., antipsychotic drugs) to treat schizophrenia was discontinued temporarily because of general anesthesia.…”

Section: Occurrences Of Nms In Fields Other Than Psychiatrymentioning

confidence: 99%

Neuroleptic malignant syndrome in fields other than psychiatry

Shimada

Kase

Nakatsuru

et al. 2023

Oral Science International

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Neuroleptic malignant syndrome (NMS) is an adverse effect of drugs, mainly neuroleptics. It is characterized by problems related to the autonomic nervous system (such as hyperthermia, diaphoresis, and tachycardia) and extrapyramidal symptoms (such as muscle rigidity and tremor). After onset, NMS progresses rapidly and without treatment, becomes life‐threatening. In recent years, NMS has become better recognized, and treatment has improved; most cases are now curable before becoming dangerous. Most NMS reports are from psychiatrists or neurologists; few are from other specialized clinicians. However, nonpsychiatric clinicians, such as surgeons, emergency physicians, orthopedists, and oral surgeons, sometimes must administer neuroleptic drugs. Although NMS is rare, its effects on patients may be debilitating, and this places a heavy burden on clinicians. Thus, not only psychiatrists but also clinicians in various other fields should understand this illness. This article describes NMS in fields other than psychiatry and its diagnosis, risk factors, and treatment strategies.

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"Brief" Aripiprazole-induced Neuroleptic Malignant Syndrome with Symptoms that Only Lasted a Few Hours

Cited by 7 publications

References 16 publications

"Differential diagnosis between Pick’s Dementia and Dementia with Lewy body deciphered by the development of neuroleptic malignant syndrome: a case report"

"Differential diagnosis between Pick’s Dementia and Dementia with Lewy body deciphered by the development of neuroleptic malignant syndrome: a case report"

A Case of Neuroleptic Malignant Syndrome in the Context of Lithium Toxicity and Aripiprazole Use

Neuroleptic malignant syndrome in fields other than psychiatry

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