Lethal catatonia and neuroleptic malignant syndrome. A dopamine receptor shut-down hypothesis.

Abstract

BACKGROUND:

Lethal catatonia and neuroleptic malignant syndrome (NMS) have been suggested to have a common neurochemical cause. We hypothesise that both conditions may be due to a sudden and massive blockade of dopamine neurotransmitters.

METHOD:

NMS was diagnosed in psychotic in-patients treated with neuroleptics if four features were present: diffuse severe rigidity, altered level of consciousness, hyperpyrexia and autonomic instability.

RESULTS:

Over three years, five NMS cases were diagnosed. Two presented with catatonic features and were diagnosed as acute reactive psychosis. Their neuroleptic doses were small, arguing for a particular sensitivity in these two cases.

CONCLUSION:

The sensitivity of two patients with catatonic features who developed NMS with small doses of neuroleptics supports a common neurochemical basis for the two conditions.

• Authors: A A Osman, M H Khurasani
• Journal: The British journal of psychiatry : the journal of mental science (Br J Psychiatry) Vol. 165 Issue 4 Pg. 548-50 (Oct 1994) ISSN: 0007-1250 [Print] England
• PMID: 7804674 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antipsychotic Agents
• Receptors, Dopamine

Topics

• Adult
• Antipsychotic Agents (adverse effects)
• Catatonia (etiology, physiopathology)
• Female
• Humans
• Male
• Neuroleptic Malignant Syndrome (etiology, physiopathology)
• Prospective Studies
• Psychotic Disorders (drug therapy)
• Receptors, Dopamine (drug effects, physiology)
• Risk Factors