Neuroleptic Malignant Syndrome

Pileggi, D; Cook, Aaron M.

doi:10.1177/1060028016657553

Cited by 88 publications

(76 citation statements)

References 47 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[20] In our case, dantrolene sodium was not effective to improve the patient's symptoms. Dantrolene has been routinely used for NMS treatment, [19] while dantrolene is not universally accepted as a treatment for NMS.…”

Section: Discussionmentioning

confidence: 64%

“…Dantrolene has been routinely used for NMS treatment, [19] while dantrolene is not universally accepted as a treatment for NMS. [20,21] If the patient is demonstrating mild to moderate symptoms of rigidity and fever, dantrolene may be effective earlier in NMS presentation. [20] In contrast, for severe cases, dantrolene used as monotherapy is not recommended for treating NMS and may actually be associated with an increase in mortality and hepatitis.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is uncertainty in the boundaries between malignant catatonia and NMS, [20,23] NMS is considered as antipsychotic medication induced form of malignant catatonia. [4–7] If history excludes exposure to an antipsychotic, the diagnosis of malignant catatonia would be apparent.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia

Ohi¹,

Kuwata

Shimada³

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:Malignant catatonia (MC) is a disorder consisting of catatonic symptoms, hyperthermia, autonomic instability, and altered mental status. Neuroleptic malignant syndrome (NMS) caused by antipsychotics is considered a variant of MC. Benzodiazepine (BZD) medications are safe and effective treatments providing rapid relief from MC. This case study reports a detailed clinical course of a case of MC associated with schizophrenia initially diagnosed as NMS that responded successfully to BZDs but not to dantrolene.Case presentation:A 53-year-old man with schizophrenia was admitted to the psychiatric hospital because of excitement, monologue, muscle rigidity, and insomnia. In the 3 days before admission, the patient had discontinued his medications after his family member's death. He presented with hyperthermia, tachycardia, hypertension, excessive sweating, and an elevated serum creatine phosphokinase (CPK) level. On the basis of these features, he was suspected to have NMS. The patient was treated with dantrolene for 7 days without improvement despite having a normalized serum CPK level. The patient was transferred to our university hospital for an in-depth examination and treatment of his physical status. Infection and pulmonary embolism were excluded as possible causes. To treat his excitement and auditory hallucination, an intravenous drip (IVD) of haloperidol was initiated, but this treatment increased the patient's catatonic and psychotic symptoms, although his serum CPK level had remained within a normal range. As a result, the treatment was changed to diazepam. After an IVD of diazepam, the patient's symptoms rapidly improved, and the IVD was subsequently replaced with oral administration of lorazepam. Eventually, the patient was diagnosed with MC associated with schizophrenia. BZD therapy was dramatically effective.Conclusion:Catatonia, MNS, and MC may be due to a common brain pathophysiology and these conditions may be in a spectrum, although uncertainty in the boundaries among conditions, and the BZD treatment may be useful. Most importantly, catatonia has not been described as a subtype of schizophrenia on the basis of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria, and the medications for catatonia and schizophrenia are different. Antipsychotics are not effective in relieving catatonia, or they may induce NMS, whereas BZDs are effective for treating both MC and NMS.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia

Ohi¹,

Kuwata

Shimada³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…It has been noted that dantrolene may be effective in treating hyperthermia from many causes unrelated to MH caused by anesthesia [12]. On the basis of the similarity between a variety of drug-induced hyperthermic syndromes and MH, dantrolene has been used to effectively treat several syndromes, such as the neuroleptic malignant syndrome, 3,4-methylenedioxy-methamphetamine toxicity, and hyperthermia related to the new onset of juvenile diabetes in adolescents [13][14][15]. …”

Section: Discussionmentioning

confidence: 99%

Dantrolene treatment in a patient with uncontrolled hyperthemia after general anesthesia: a case report of suspected malignant hyperthermia - A case report -

et al. 2018

View full text Add to dashboard Cite

Fever (body temperature above 38°C) is relatively common during the first few days after general anesthesia. Postoperative fever is usually caused by the inflammation induced by surgery and resolves spontaneously; however, it can be a manifestation of a serious complication such as malignant hyperthermia. We report a case of postoperative hyperthermia (body temperature > 40°C) that was refractory to conventional anti-pyretic measures and finally resolved with dantrolene administration.

show abstract

“…However, others have suggested that the choice of antipsychotic should be one with low D2 affinity. 11 It is important to wait for resolution of NMS before rechallenge with some suggesting a ‘washout’ period of 2 weeks. 11 It is also advisable to restart at a low dose and to monitor for re-emerging signs of NMS.…”

Section: Discussionmentioning

confidence: 99%

Neuroleptic malignant syndrome following catatonia: Vigilance is the price of antipsychotic prescription

Reilly

Cross

Taylor

et al. 2017

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Objectives:To describe a case of neuroleptic malignant syndrome following antipsychotic treatment of catatonia, highlighting the potentially serious complications of this rare adverse drug reaction.Methods:We present a case report of a patient who developed this syndrome with various sequelae.Results:The patient developed neuroleptic after being treated with lorazepam and olanzapine for catatonia. He subsequently developed the complications of rhabdomyolysis, acute kidney injury, pulmonary embolism, urinary retention and ileus. He received high-dose lorazepam, anticoagulation and intravenous fluids. Antipsychotic medication in the form of haloperidol was reinstated with no adverse effect, and he went on to make a full recovery.Conclusions:This case illustrates the potential life-threatening complications of neuroleptic malignant syndrome and the need for a low index of clinical suspicion. It also highlights the lack of evidence for treatment of catatonia, including the use of antipsychotics.

show abstract

Neuroleptic Malignant Syndrome

Cited by 88 publications

References 47 publications

Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia

Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia

Dantrolene treatment in a patient with uncontrolled hyperthemia after general anesthesia: a case report of suspected malignant hyperthermia - A case report -

Neuroleptic malignant syndrome following catatonia: Vigilance is the price of antipsychotic prescription

Contact Info

Product

Resources

About