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    Leukodystrophy Presenting as Hyperactivity and Bipolarity with Uncommon Adverse Drug Reaction.
    Indian J Psychol Med 2017 Mar-Apr;39(2):202-204
    Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
    Leukodystrophy is a group of demyelinating neurodegenerative diseases of brain with varied presentation and multiple etiologies. Prognosis is predominantly dismal. Misdiagnosis and wrong treatment are common in this group of rare neurological disorders, especially when it presents with psychiatric symptoms. Read More

    Severe hyponatremia in a patient with schizophrenia associated with prolonged consciousness disturbance.
    CEN Case Rep 2017 May 18;6(1):5-11. Epub 2016 Oct 18.
    Department of Nephrology and Hypertension, Faculty of Blood Purification, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
    Hyponatremia presents with various central nervous system symptoms during its course and treatment. We treated a patient who presented with a prolonged consciousness disorder and was suspected of having complications of neuroleptic malignant syndrome and osmotic demyelination syndrome (ODS) during the treatment for his hyponatremia, which was caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The patient was a 30-year-old Japanese man who had been under treatment for schizophrenia. Read More

    The Role of Amantadine Withdrawal in 3 Cases of Treatment-Refractory Altered Mental Status.
    J Psychiatr Pract 2017 May;23(3):191-199
    FRYML, WILLIAMS, PELIC, FOX, SAHLEM, ROBERT, and SHORT: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC REVUELTA: Department of Neurology and Neurosciences, Medical University of South Carolina, Charleston, SC.
    Amantadine, which was originally developed as an antiviral medication, functions as a dopamine agonist in the central nervous system and consequently is utilized in the treatment of Parkinson disease, drug-induced extrapyramidal reactions, and neuroleptic malignant syndrome. For reasons that are not entirely understood, abrupt changes in amantadine dosage can produce a severe withdrawal syndrome. Existing medical literature describes case reports of amantadine withdrawal leading to delirium, which at times has progressed to neuroleptic malignant syndrome. Read More

    Neuroleptic malignant syndrome following catatonia: Vigilance is the price of antipsychotic prescription.
    SAGE Open Med Case Rep 2017 31;5:2050313X17695999. Epub 2017 Mar 31.
    Department of Psychological Medicine, King's College Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
    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. Read More

    Pharmacist intervention to detect drug adverse events on admission to the emergency department: Two case reports of neuroleptic malignant syndrome.
    J Clin Pharm Ther 2017 May 9. Epub 2017 May 9.
    Clinical Pharmacy Department, University Hospital, Montpellier, France.
    What Is Known And Objective: Neuroleptic malignant syndrome (NMS) is a rare but severe adverse effect of antipsychotic drugs.

    Case Description: We report two cases of NMS highlighted by clinical pharmacists in an emergency unit during summer. One of them was fatal. Read More

    Psychotic and Bipolar Disorders: Antipsychotic Drugs.
    FP Essent 2017 Apr;455:23-29
    Baylor Family Medicine Residency at Garland, 601 Clara Barton Blvd. Suite 340, Garland, TX 75042.
    Antipsychotic drugs block dopamine receptors and are used to manage psychosis as well as other mental illnesses that may or may not have psychotic features, such as bipolar disorders and major depressive disorder. First-generation antipsychotic drugs are more likely to cause adverse effects such as extrapyramidal symptoms and tardive dyskinesia. Adverse effects of second-generation antipsychotic drugs typically are related to metabolic abnormalities such as weight gain, abnormal blood glucose levels, and elevated lipid levels. Read More

    Response to benzodiazepines and the clinical course in malignant catatonia associated with schizophrenia: A case report.
    Medicine (Baltimore) 2017 Apr;96(16):e6566
    aDepartment of Neuropsychiatry bClinical Training Center, Kanazawa Medical University, Ishikawa, Japan.
    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. Read More

    Neuroleptic Malignant Syndrome/Malignant Catatonia in Child Psychiatry: Literature Review and a Case Series.
    J Child Adolesc Psychopharmacol 2017 May 23;27(4):359-365. Epub 2017 Feb 23.
    4 Department of Psychiatry, University of Mississippi Medical Center , Jackson, Mississippi.
    Objective: To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents.

    Background: NMS and MC are life-threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent. Read More

    Neuroleptic Malignant Syndrome Secondary to Metoclopramide Use in an Elderly Gastroenterologic Surgery Patient.
    Gastroenterol Nurs 2017 Mar/Apr;40(2):93-100
    Richard Breeden, PharmD, BCPS, BCNSP, is Assistant Professor, South College School of Pharmacy, Critical Care Pharmacist, Methodist Medical Center of Oak Ridge, Knoxville, Tennessee. Heath Ford, PharmD, PhD, CGP, is Assistant Professor, South College School of Pharmacy, Knoxville, Tennessee. Carey Chrisman, PharmD, is Affiliate Assistant Professor, University of Tennessee College of Pharmacy, and Critical Care Pharmacist, Methodist Medical Center of Oak Ridge, Oak Ridge, Tennessee. Charles Mascioli, MD, MBA, FCCP, is Critical Care Physician, Methodist Medical Center of Oak Ridge, Oak Ridge, Tennessee.
    An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). Read More

    Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome.
    J Mov Disord 2017 May 24;10(2):99-101. Epub 2017 Mar 24.
    Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
    We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS). The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging. Read More

    Atypical Neuroleptic Malignant Syndrome Associated with Use of Clozapine.
    Case Rep Emerg Med 2017 20;2017:2174379. Epub 2017 Feb 20.
    Emergency Department, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
    The Neuroleptic Malignant Syndrome (NMS) is a medical emergency of infrequent presentation in the emergency department, which is associated with the use of psychiatric drugs, such as typical and atypical antipsychotics. Our case addresses a 55-year-old patient diagnosed with undifferentiated schizophrenia for 10 years, who had been receiving clozapine and clonazepam as part of their treatment. This patient presents the symptoms of Neuroleptic Malignant Syndrome without fever, which improves with treatment especially with the withdrawal of clozapine. Read More

    A Retrospective Cohort Study of Acute Kidney Injury Risk Associated with Antipsychotics.
    CNS Drugs 2017 Apr;31(4):319-326
    Titus Family Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
    Background: A recent large database analysis raised concerns of potential acute kidney injury (AKI) risk associated with antipsychotics. However, whether individual atypical and typical antipsychotics are associated with differential AKI risks has not been investigated.

    Objective: The current study compared the risks of AKI and known causes of AKI associated with a broad range of atypical and typical antipsychotics. Read More

    Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review.
    Case Rep Crit Care 2017 30;2017:1951965. Epub 2017 Jan 30.
    Department of Medicine, Maricopa Medical Center, Phoenix, AZ, USA; College of Medicine, University of Arizona, Phoenix, AZ, USA; College of Medicine, Mayo Clinic, Scottsdale, AZ, USA.
    Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. Read More

    A systematic review of sex and age factors in neuroleptic malignant syndrome diagnosis frequency.
    Acta Psychiatr Scand 2017 May 1;135(5):398-408. Epub 2017 Feb 1.
    Veteran Affairs Boston Healthcare System, Boston MA and Harvard Medical School Department of Psychiatry, Boston, MA, USA.
    Objective: To examine sex and age distributions in neuroleptic malignant syndrome (NMS) patients based on a systematic literature review.

    Method: EMBASE and PubMed databases were searched to identify any observation of NMS published from January 1, 1998 through November 1, 2014 that was accessible and interpretable (using language translation software). Redundant and equivocal reports were excluded. Read More

    Neuroleptic malignant syndrome: an easily overlooked neurologic emergency.
    Neuropsychiatr Dis Treat 2017 16;13:161-175. Epub 2017 Jan 16.
    Department of Clinical Medicine, Section of Psychiatry, University of Bergen, Bergen, Norway.
    Neuroleptic malignant syndrome is an unpredictable iatrogenic neurologic emergency condition, mainly arising as an idiosyncratic reaction to antipsychotic agent use. It is characterized by distinctive clinical features including a change in mental status, generalized rigidity, hyperpyrexia, and dysautonomia. It can be lethal if not diagnosed and treated properly. Read More

    A Case of Olanzapine-Induced Fever.
    Psychopharmacol Bull 2017 Jan;47(1):45-47
    Drs. Yang, MD, Chen, MD, ScD, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan. Dr. Ying-Yeh Chen, MD, ScD, Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan.
    Olanzapine, a frequently used second-generation antipsychotic, has rarely been implicated as a cause of drug-induced fever in the absence of neuroleptic malignant syndrome. We describe a patient who developed isolated fever following olanzapine monotherapy, which subsided after discontinuation of olanzapine. Blockade of dopaminergic receptors and elevated cytokines concentration are possible mechanisms of fever development during treatment with olanzapine. Read More

    Neuroleptic Malignant Syndrome Associated with Valproate in an Adolescent.
    Clin Psychopharmacol Neurosci 2017 Feb;15(1):76-78
    Department of Child and Adolescent Psychiatry, Mersin University School of Medicine, Mersin, Turkey.
    Neuroleptic malignant syndrome (NMS) is a life-threatening idiosyncratic reaction that usually occurs after the administration of antipsychotic drugs. Antidepressants, benzodiazepines, and antiepileptic drugs are also suggested to be associated with NMS. It is believed to result from a dopaminergic blockade in the central nervous system. Read More

    Acute Dystonia Versus Neuroleptic Malignant Syndrome Without Fever in an Eight-Year-Old Child.
    Pediatr Emerg Care 2017 Jan;33(1):38-40
    From the *Department of Emergency Medicine, The Western Pennsylvania Hospital; and †Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, PA.
    Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of the use of certain medications. It is being seen more often in the pediatric population because of the increasing use of both typical and atypical antipsychotics in children. Rapid recognition of NMS is important to emergency physicians because timely treatment can be life saving. Read More

    A Validation Study of the International Consensus Diagnostic Criteria for Neuroleptic Malignant Syndrome.
    J Clin Psychopharmacol 2017 Feb;37(1):67-71
    From the *VA Boston Healthcare System, Boston MA; †Department of Psychiatry, Harvard Medical School, ‡Boston Children's Hospital, Boston MA; §Faculty of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; ∥Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
    Background: Neuroleptic malignant syndrome requires prompt recognition for effective management, but there are no established diagnostic criteria. This is the first validation study of recently published international expert consensus (IEC) diagnostic criteria, which include priority points assigned on the basis of the importance of each criterion for making a diagnosis of neuroleptic malignant syndrome.

    Methods: Data were extracted from 221 archived telephone contact reports of clinician-initiated calls to a national telephone consultation service from 1997 to 2009; each case was given a total priority point score on the basis of the IEC criteria. Read More

    Agitation Management in Pediatric Males with Anti-N-Methyl-D-Aspartate Receptor Encephalitis.
    J Child Adolesc Psychopharmacol 2016 Dec 22;26(10):939-943. Epub 2016 Sep 22.
    3 Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital , Chicago, Illinois.
    Objectives: Severe agitation is a common symptom in pediatric cases of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis-an autoimmune encephalitis with prominent neuropsychiatric symptoms. Agitation is a major barrier to treatment of the underlying disease process and increases patients' risk of harming themselves and others. Furthermore, male patients often have undetectable tumors and are especially at risk for extended hospitalization, but have been infrequently studied. Read More

    Neurotoxicity and nephrotoxicity caused by combined use of lithium and risperidone: a case report and literature review.
    BMC Pharmacol Toxicol 2016 Dec 14;17(1):59. Epub 2016 Dec 14.
    Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    Background: Combination lithium, a mood stabilizer, and risperidone, an atypical antipsychotic drug, is widely used for treatment of psychotic disorders. Rare reports concern severe adverse drug reaction in multiple organic systems with their combined use. We report two episodes of neurotoxicity and nephrotoxicity in a patient following the combined use of lithium and risperidone. Read More

    Probable clozapine-induced parenchymal lung disease and perimyocarditis: a case report.
    BMC Psychiatry 2016 Dec 8;16(1):438. Epub 2016 Dec 8.
    Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway.
    Background: Clozapine is the archetypical atypical antipsychotic, its primary indication being treatment resistant schizophrenia. Severe side effects caused by clozapine, including leukopenia, agranulocytosis, and myocarditis, are well known. A rarely described side effect is concurrent perimyocarditis and parenchymal lung disease. Read More

    A case of severe movement disorder with GNAO1 mutation responsive to topiramate.
    Brain Dev 2017 May 6;39(5):439-443. Epub 2017 Jan 6.
    Department of Pediatrics, Jichi Medical University, Tochigi, Japan.
    We report the case of a 19-year-old female patient who had progressive chorea associated with a GNAO1 mutation. Chorea was refractory to multiple anticonvulsants, and the patient suffered from tiapride-induced neuroleptic malignant syndrome. After identification of a GNAO1 missense mutation at the age of 18years, topiramate treatment was initiated and the frequency of chorea decreased dramatically. Read More

    Reversible splenial lesion syndrome with a hyperosmolar hyperglycemic state and neuroleptic malignant syndrome caused by olanzapine.
    J Diabetes Investig 2017 May 6;8(3):392-394. Epub 2017 Jan 6.
    Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
    A 27-year-old woman with panic disorder taking 20 mg olanzapine daily for 4 months was admitted to Mito Kyodo General Hospital, Mito, Ibaraki, Japan, because of disturbed consciousness with fever, hyperglycemia, hyperosmolarity and elevated creatine phosphokinase. She was diagnosed with a hyperosmolar hyperglycemic state and neuroleptic malignant syndrome. Brain magnetic resonance imaging showed transiently restricted diffusion in the splenium of the corpus callosum, with a high signal intensity on diffusion-weighted imaging. Read More

    Risperidone-Associated Rhabdomyolysis Without Neuroleptic Malignant Syndrome: A Case Report.
    J Clin Psychopharmacol 2017 Feb;37(1):105-106
    Department of Medicine, Hospital Sultanah Nora Ismail, Batu Pahat, Johor Darul Takzim, Malaysia Department of Medicine, Hospital Enche' Besar Hajjah Khalsom, Kluang, Johor Darul Takzim, Malaysia Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia

    Commentary on 3 Unusual Cases Involving Electroconvulsive Therapy.
    J Psychiatr Pract 2016 Nov;22(6):490-491
    KAHN: Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
    Well-established practice guidelines and a solid body of evidence underpin the safe and effective use of electroconvulsive therapy (ECT), primarily in mood disorders. In this issue of the journal, 3 case reports deal with situations that fall outside of the usual guidelines: treatment resistance to ECT overcome by combined use with antidepressant medication; use of ECT in the presence of polymyositis; and use of ECT for an unusually severe case of neuroleptic malignant syndrome, assisted by consultation from an online expert resource. The value of case reports and expert consultation in situations in which there is little or no evidence from clinical trials is also discussed. Read More

    Use of Expert Consultation in a Complex Case of Neuroleptic Malignant Syndrome Requiring Electroconvulsive Therapy.
    J Psychiatr Pract 2016 Nov;22(6):484-489
    WITTENAUER WELSH, JANJUA, and HERMIDA: Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA GARLOW: University of Wisconsin Psychiatric Institute and Clinics, Madison, WI MCCORMICK: University of the Virgin Islands, St Thomas, VI, and Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA HUSAIN: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX and Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, NC MAIXNER: Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI WEINER: Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, NC.
    Our team at Emory University Hospital contacted experts at the National Network of Depression Centers (NNDC) for clinical guidance concerning a patient with schizophrenia hospitalized in the intensive care unit with a complex case of prolonged delirium secondary to neuroleptic malignant syndrome (NMS). Through the NNDC, leading psychiatrists across the United States with expertise in electroconvulsive therapy (ECT) provided us with treatment strategies based on experience in our area of concern. This report describes our use of ECT to treat severe NMS in this patient with schizophrenia, utilizing the recommendations made by the NNDC's ECT experts concerning electrode position, number and frequency of treatments, and selection of anesthetic induction agents. Read More

    Olanzapine Long-Acting Injections After Neuroleptic Malignant Syndrome: Two Case Reports.
    J Clin Psychopharmacol 2016 Dec;36(6):733-735
    School of Medicine University of Zagreb and Department of Psychiatry Clinical Hospital Centre Zagreb Zagreb, Croatia Department of Psychiatry Clinical Hospital Centre Zagreb Zagreb, Croatia and Faculty of Medicine Josip Juraj Strossmayer University of Osijek Osijek, Croatia School of Medicine University of Zagreb and Department of Laboratory Diagnostics Clinical Hospital Centre Zagreb Department of Laboratory Diagnostics Clinical Hospital Centre Zagreb Zagreb, Croatia School of Medicine University of Zagreb and Department of Psychiatry Clinical Hospital Centre Zagreb Zagreb, Croatia Department of Psychiatry Clinical Hospital Centre Zagreb Zagreb, Croatia.

    Venous Thromboembolism Following Dantrolene Treatment for Neuroleptic Malignant Syndrome.
    Clin Psychopharmacol Neurosci 2016 Nov;14(4):399-401
    Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    Neuroleptic malignant syndrome (NMS) is one of the most severe iatrogenic emergencies in clinical service. The symptoms including sudden consciousness change, critical temperature elevation and electrolytes imbalance followed by mutli-organ system failure were common in NMS. In addition to aggressive interventions with intravenous fluid resuscitation and antipyretics, several antidotes have been suggested to prevent further progression of the muscle damage. Read More

    Posterior reversible encephalopathy syndrome in Parkinson disease probably caused by prominent supine hypertension and blood pressure fluctuation.
    Rinsho Shinkeigaku 2016 Nov 21;56(11):754-758. Epub 2016 Oct 21.
    Department of Neurology, Japanese Red Cross Nagoya Daini Hospital.
    We present the case of a 77-year-old man with a 10-year history of Parkinson disease (PD), who developed posterior reversible encephalopathy syndrome (PRES). We diagnosed the case as PRES based on clinical features and MRI findings. He experienced orthostatic hypotension and supine hypertension, including nocturnal hypertension. Read More

    Catatonic Symptoms Appearing before Autonomic Symptoms Help Distinguish Neuroleptic Malignant Syndrome from Malignant Catatonia.
    Intern Med 2016;55(19):2893-2897. Epub 2016 Oct 1.
    Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Japan.
    A 42-year-old Japanese woman with a 10-year history of schizophrenia was admitted due to a disturbance in consciousness that met the diagnostic criteria for both neuroleptic malignant syndrome (NMS) and malignant catatonia. Despite systemic supportive treatments, the catatonic symptoms preceding autonomic symptoms persisted. The symptoms improved after lorazepam administration, leading to a retrospective diagnosis of malignant catatonia. Read More

    Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis.
    Case Rep Crit Care 2016 18;2016:2587963. Epub 2016 Sep 18.
    Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY 11432, USA.
    Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH), neuroleptic malignant syndrome (NMS), and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Read More

    Mild Hypothermia in a Child with Low-Dose Risperidone.
    Z Kinder Jugendpsychiatr Psychother 2016 Sep 29:1-3. Epub 2016 Sep 29.
    1 Dept. of Psychiatry and Psychotherapy III, University of Ulm, Germany.
    Risperidone is a widely used, second-generation antipsychotic approved for treating schizophrenia as well as for treating aggression in children and adolescents with mental retardation. The substance has a well-established risk profile including alterations of body temperature. Apart from hyperthermia with and without full-blown malignant neuroleptic syndrome, low body temperatures (hypothermia) have also been reported anecdotally, usually appearing in the context of comedication. Read More

    Carisoprodol withdrawal syndrome resembling neuroleptic malignant syndrome: Diagnostic dilemma.
    J Anaesthesiol Clin Pharmacol 2016 Jul-Sep;32(3):387-8
    Department of Orthopedics, Dayanand Medical College, Ludhiana, Punjab, India.
    Soma (Carisoprodol) is N-isopropyl-2 methyl-2-propyl-1,3-propanediol dicarbamate; a commonly prescribed, centrally acting skeletal muscle relaxant. Neuroleptic malignant syndrome (NMS) is a potentially life-threatening adverse effect of antipsychotic agents. Although diagnostic criteria for NMS have been established, it should be recognized that atypical presentations occur and more flexible diagnostic criteria than currently mandated, may be warranted. Read More

    Diagnosis and implications in the therapeutic management of patient with afebrile neurolepctic malignant syndrome.
    Oxf Med Case Reports 2016 Sep 6;2016(9):omw067. Epub 2016 Sep 6.
    Department of Psychiatry, Faculty of Medical Sciences, University of Campinas (Unicamp) , Rua Tessália Vieira de Camargo , 126, Campinas 13083-894, Brazil.
    This report aims at raising clinical awareness for the diagnosis of atypical presentations of neuroleptic malignant syndrome (NMS). We describe the case of a female patient with NMS symptoms, except fever, after starting the use of chlorpromazine. The afebrile condition delayed the consideration of NMS by the emergency clinicians who provided her initial assessment. Read More

    Reconsidering Olanzapine as a Possible Culprit for Drug Fever, defying "Incomplete Neuromalignant Syndrome".
    J La State Med Soc 2016 Jul-Aug;168(4):123-4. Epub 2016 Aug 15.
    University Health Hospitals-Shreveport, LA.
    This case is important because it is the first time Olanzapine-induced fever has been described in the absence of neuroleptic malignant syndrome. In the context of the available antipsychotics with the atypical agents dominating the pool, only few of those are known to be well tolerated among the patients. Fever may be looked at by the physicians as a minor problem yet, it can be disabling to the large set of patients. Read More

    Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Potential Mimic of Neuroleptic Malignant Syndrome.
    Pediatr Neurol 2016 Oct 25;63:71-2. Epub 2016 Jun 25.
    Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri. Electronic address:
    Background: Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disorder characterized by behavioral changes, dyskinesia, and autonomic instability.

    Patient Description: We describe a 14-year-old girl who initially presented with acute behavioral changes and seizures and who over a 2-week period developed high fever, tachycardia, and elevated blood pressures.

    Results: Because she received multiple medications including anticonvulsants and a neuroleptic, our patient was initially diagnosed with neuroleptic malignant syndrome, a disorder characterized by autonomic dysfunction, hyperthermia, muscle rigidity, and mental status changes usually caused by the use of a neuroleptic agent. Read More

    Pyrexia: aetiology in the ICU.
    Crit Care 2016 Sep 1;20:247. Epub 2016 Sep 1.
    Department of Medicine, Royal Inland Hospital, 311 Columbia Street, Kamloops, BC, V2C 2T1, Canada.
    Elevation in core body temperature is one of the most frequently detected abnormal signs in patients admitted to adult ICUs, and is associated with increased mortality in select populations of critically ill patients. The definition of an elevated body temperature varies considerably by population and thermometer, and is commonly defined by a temperature of 38.0 °C or greater. Read More

    Malignant Catatonia and Neuroleptic Malignant Syndrome in Relation to Disulfiram Overdose.
    Indian J Psychol Med 2016 Jul-Aug;38(4):344-7
    Department of Psychiatry, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India.
    Disulfiram is a widely used drug in the management of alcohol dependence syndrome as an aversive agent. Although a drug of high efficacy, it has a large number of side effects. Disulfiram-induced catatonia is a known rare side effect of the drug and herein we report a case of what appeared to be the sequential development of malignant catatonia and neuroleptic malignant syndrome in a patient with a diagnosis of alcohol dependence syndrome and co-morbid paranoid schizophrenia following disulfiram overdose. Read More

    Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic Use.
    Am Fam Physician 2016 Aug;94(4):276-82
    Tripler Army Medical Center, Honolulu, HI, USA.
    Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient's environment, and establishing daily routines. Family members and caregivers benefit from education about dementia symptoms and reminders that the behaviors are normal and unintentional. Read More

    Drug-Induced Extrapyramidal Syndromes: Implications for Contemporary Practice.
    Psychiatr Clin North Am 2016 09 23;39(3):391-411. Epub 2016 Jun 23.
    Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center-116A, University & Woodland Avenues, Philadelphia, PA 19104, USA.
    The development of drugs to treat psychosis is a fascinating nexus for understanding mechanisms underlying disorders of mind and movement. Although the risk of drug-induced extrapyramidal syndromes has been mitigated by the acceptance of less potent dopamine antagonists, expansive marketing and off-label use has increased the number of susceptible people who may be at risk for these neurologic effects. Clinicians need to be familiar with advances in diagnosis and management, which are reviewed herein. Read More

    Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole.
    J Clin Psychopharmacol 2016 Oct;36(5):496-9
    From the *Department of Clinical Medicine, Aalborg University; †Department of Psychiatry, Aalborg University Hospital, Aalborg; ‡Danish Medicines Agency, Copenhagen; §Centre for Child and Adolescent Mental Health, Mental Health Services; ∥Mental Health Centre Copenhagen, Department O, Capital Region of Denmark; and ¶Faculty of Health Sciences of Copenhagen University, University of Copenhagen, Copenhagen, Denmark.
    Aripiprazole is a partial dopamine agonist with only minor neurological and psychiatric adverse effects, making it a potential first-line drug for the treatment of psychiatric disorders. However, the evidence of its use in children and adolescents is rather sparse. The aim of this case study is to discuss adverse drug reaction (ADR) reports concerning aripiprazole-associated neurological and psychiatric events in children and adolescents. Read More

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