Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T14:47:41.945Z Has data issue: false hasContentIssue false
  • English
  • Français

Reintroduction of antipsychotics in a patient with clozapine induced neuroleptic malignant syndrome

Published online by Cambridge University Press:  13 June 2014

Kelwyn Williams  and
Rob MacPherson
Rob MacPherson
Affiliation:
Wotton Lawn Horton Road Gloucester GL1 3PX, England
Get access Rights & Permissions [Opens in a new window]

Abstract

We report a case of neuroleptic malignant syndrome (NMS) secondary to clozapine treatment in which re-introduction of two different antipsychotics led to elevation of creatinine kinase (CK) levels without associated symptoms of NMS. The significance of CK levels as a marker for NM S is discussed in the light of previous findings in this area. We suggest clinical guidelines for antipsychotic rechallenge after the occurrence of NMS.

Keywords

Neuroleptic malignant syndromeClozapineAntipsychoticsCreatinine kinase
Type
Case Reports
Information
Irish Journal of Psychological Medicine , Volume 14 , Issue 4 , December 1997 , pp. 147 - 148
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Keck, PE, Pope, HG, McElroy, SL. Declining frequency of neuroleptic malignant syndrome in a hospital population. Am J Psychiatry 1991; 148: 880–2.Google Scholar
2.Addonizio, G, Susman, VC, Ruth, SD. Symptoms of neuroleptic malignant syndrome in 82 consecutive in-patients. Am J Psychiatry 1986; 143: 1587–90.Google Scholar
3.Rampertaap, MP. Neuroleptic Malignant Syndrome. Southern Medical Journal 1986; 79: 331–6.CrossRefGoogle ScholarPubMed
4.Weller, M, Kornhuber, J. Clozapine rechallenge after an episode of neuroleptic malignant syndrome. Br J Psychiatry 1992; 161: 855–6.CrossRefGoogle ScholarPubMed
5.Miller, DD, Sharafuddin, MJA, Kathol, RG. A case of clozapine-induced neuroleptic malignant syndrome. J Clinical Psychiatry 1991; 52(3): 99–101.Google ScholarPubMed
6.Rosebush, PI, Stewart, TD, Gelenberg, AJ. Twenty neuroleptic rechallenges after neuroleptic malignant syndrome in 15 patients. J Clin Psychiatry 1989; 50: 295–8.Google ScholarPubMed
7.Barnes, T. Antipsychotic drugs and their side effects. Academic Press, 1993.Google Scholar
8.Goldwasser, HD, Hooper, JF, Spears, NM. (1989) Concomitant treatment of neuroleptic malignant syndrome and psychosis. Br J Psychiatry 1989; 54: 102–4.CrossRefGoogle Scholar
9.Pelonero, AL, Levenson, JL, Silverman, JJ. Neuroleptic therapy following neuroleptic malignant syndrome. Psychosomatics 1985; 26: 946–8.CrossRefGoogle ScholarPubMed
10.Lee, H, Ryan, J, Mullett, Get al.NMS associated with the use of risperidone, an atypical antipsychotic agent. Human Psychopharmacology 1994; 9(40): 303–5.CrossRefGoogle Scholar
11. Committee on Safety of Medicines. Personal Communication. 1995.Google Scholar
12. Clozaril Newsletter 1995; 12.Google Scholar
13.Pope, HG, Keck, PE, McElroy, SL. Frequency and presentation of NMS in a large psychiatric hospital. Am J Psychiatry 1986; 143: 1227–33.Google Scholar
14.O'Dwyer, AM, Sheppard, NP. The role of creatine kinase in the diagnosis of neuroleptic malignant syndrome. Psychological Med 1993; 23: 323–6.CrossRefGoogle ScholarPubMed
15.Dose, M, Apelt, S, Emrich, HM. Carbamazepine as an adjunct to antipsychotic therapy. Psychiatry Research 1987; 22(4): 303–10.CrossRefGoogle ScholarPubMed
16.Lazarus, A, Mann, SC, Caroff, SN. The Neuroleptic Malignant Syndrome and related conditions. Clinical Practice Series No 6. American Psychiatric Press, 1989.Google Scholar