Neuroleptic malignant syndrome and clozapine monotherapy.

Abstract

OBJECTIVE:

This report identifies neuroleptic malignant syndrome (NMS) occurring on a steady state dosage of clozapine monotherapy.

CLINICAL PICTURE:

An outpatient presented with a recent history of stiffness and soreness of his legs, dizziness, polydipsia, polyuria, abdominal and chest pains. After admission to a general hospital, further symptomatology was identified including: pallor, diaphoresis, nausea, confusion, agitation, decrease in normal reflexes, minimally reactive pupils and rigid limbs.

TREATMENT:

Intravenous (I/V) diazepam was administered but failed to decrease the agitation and confusion. He was sedated with the administered of I/V droperadol, intubated and placed on a ventilator with circulatory supports for 4 days.

OUTCOME:

On day five he was extubated and transfered to a medical ward. All laboratory values had returned to normal values by this time. The patient was subsequently discharged.

CONCLUSIONS:

Neuroleptic malignant syndrome can occur at any stage of clozapine treatment, and the patient can be rechallenged after such an episode. This person was rechallenged and after 6 months of treatment has suffered no further recurrence of NMS.

• Authors: R Chatterton, S Cardy, T M Schramm
• Journal: The Australian and New Zealand journal of psychiatry (Aust N Z J Psychiatry) Vol. 30 Issue 5 Pg. 692-3 (Oct 1996) ISSN: 0004-8674 [Print] England
• PMID: 8902179 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Antipsychotic Agents (adverse effects, therapeutic use)
• Clozapine (adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Humans
• Male
• Middle Aged
• Neuroleptic Malignant Syndrome (diagnosis)
• Neurologic Examination (drug effects)
• Schizophrenia (drug therapy)
• Schizophrenic Psychology