Neuroleptic malignant syndrome induced by concomitant use of risperidone and quetiapine

Demır, Mustafa; Demir, Tuba Öztürk; Yaylacı, Selçuk; Yıldız, Hüseyin Bekir; Taycı, İbrahim; Baydar, Mustafa

doi:10.4103/2348-3334.177643

Cited by 2 publications

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“…A case of concomitant use of quetiapine and risperidone has been reported in the literature. 14 Clinicians have to keep in mind that NMS could appear with all antipsychotics, including the newest. Furthermore, in some second generation antipsychotics atypical features would be observed as fewer intense extrapyramidal symptoms or with less fever making the diagnosis more difficult.…”

Section: Discussionmentioning

confidence: 99%

Neuroleptic Malignant Syndrome: A Case Responding to Electroconvulsive Therapy Plus Bupropion

Foguet-Boreu

Coll-Negre²,

Serra-Millàs

et al. 2018

Clinics and Practice

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Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT. The symptoms that had motivated the admission gradually remitted and the patient was discharged home. Bupropion increases dopaminergic activity in both the nucleus accumbens and the prefrontal cortex. Therefore, from a physiopathological standpoint, bupropion has a potential role in treating NMS. However, there is scarce evidence supporting this approach and therefore future cases should be carefully considered.

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Section: Discussionmentioning

confidence: 99%

Neuroleptic Malignant Syndrome: A Case Responding to Electroconvulsive Therapy Plus Bupropion

Foguet-Boreu

Coll-Negre²,

Serra-Millàs

et al. 2018

Clinics and Practice

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“…Neuroleptic malignant syndrome (NMS) is a rare idiosyncratic disorder caused by an adverse reaction to neuroleptics that occurs in 2% to 3% of patients, who are treated with neuroleptics and has a mortality risk of 10% to 20% (1). This syndrome may lead to death or permanent damages as neurological effects if not diagnosed and treated quickly (2,3).…”

Section: Introductionmentioning

confidence: 99%

Ileus as a Sign of Neuroleptic Malignant Syndrome: A Case Report and Review of the Literature

Elyasi

Azizi

Shirzad

et al. 2018

Iran J Psychiatry Behav Sci

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Introduction: Neuroleptic malignant syndrome (NMS) is a rare and unpredictable adverse reaction associated with the use of firstgeneration and second-generation antipsychotics. Atypical antipsychotics may create atypical forms of NMS due to their different pharmacological characteristics. Decreased dopaminergic tone in the brain is coincided with a dysregulation of autonomic nervous system in this syndrome. This study reports on a case, in which current views occurred during the course of the disease is among rare symptoms. This paper reports on an NMS case, in which current views and symptoms that occurred during the course of the disease were rare symptoms that are not usually found in NMS. Case Presentation: The patient was a 43-year-old male with schizoaffective disorder under treatment with clozapine and risperidone. He had lead pipe muscle rigidity, stupor, fever and autonomic dysfunction, increased levels of creatinine phosphokinase, leukocytosis, and microglobulina. Levenson's criteria is widely accepted for diagnosis of NMS. Six days after admission to the psychosomatic ward, the patient had ileus. Due to lack of response to neomycin and GI rest and embedding NG tube, the patient underwent therapeutic sigmoidoscopy and colonoscopy for decompression. Conclusions: Diagnosis of NMS is largely based on clinical history and the presence of specific clinical symptoms. Antipsychotics polypharmacy increases the NMS risk. Mechanisms underlying the development of ileus in the patient are speculative and multifactorial. Paralytic ileus can be one of the autonomic dysfunctions in NMS. Furthermore, NMS is categorized in differential diagnosis of acute abdomen caused by the pseudo-obstruction. All physicians should be aware of this possibility when faced with patients under treatment with neuroleptics.

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Neuroleptic malignant syndrome induced by concomitant use of risperidone and quetiapine

Cited by 2 publications

References 0 publications

Neuroleptic Malignant Syndrome: A Case Responding to Electroconvulsive Therapy Plus Bupropion

Neuroleptic Malignant Syndrome: A Case Responding to Electroconvulsive Therapy Plus Bupropion

Ileus as a Sign of Neuroleptic Malignant Syndrome: A Case Report and Review of the Literature

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