2,765 results match your criteria Neuroleptic Malignant Syndrome


Malignant Catatonia: severity, treatment and outcome - a systematic case series analysis.

World J Biol Psychiatry 2021 May 5:1-28. Epub 2021 May 5.

Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Malignant catatonia (MC) is a rare, yet potentially life-threatening neuropsychiatric condition. Evidence on its therapy is weak, treatment recommendations are scarce and predominantly unprecise. The aim of this study was to compare the effectiveness of different MC treatment approaches regarding outcome and severity of MC. Read More

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Neuroleptic malignant syndrome in a patient with moderate intellectual disability treated with olanzapine: A case report.

Clin Case Rep 2021 Apr 15;9(4):2404-2408. Epub 2021 Mar 15.

Department of Liaison Psychiatry University Hospital Waterford Waterford Ireland.

This case demonstrates the challenges encountered in a case of Neuroleptic Malignant Syndrome in a young woman with moderate Intellectual Disability. Read More

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Anti N-Methyl-D-Aspartate (NMDA) receptor encephalitis: from psychosis to cognitive impairment.

Clin Case Rep 2021 Apr 23;9(4):2174-2178. Epub 2021 Feb 23.

Department of Psychiatry Roozbeh Hospital School of Medicine Tehran University of Medical Sciences Tehran Iran.

In this study, while presenting a clinical case with early psychiatric manifestations, we emphasized the need to pay attention to neurological diagnoses such as Anti N-Methyl-D-Aspartate Receptor (NMDAR) encephalitis at the time of manifestation of these common symptoms. Read More

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Neuroleptic Malignant Syndrome: A Case of Unknown Causation and Unique Clinical Course.

Cureus 2021 Mar 25;13(3):e14113. Epub 2021 Mar 25.

Internal Medicine, Medical College of Wisconsin, Milwaukee, USA.

Neuroleptic malignant syndrome (NMS) is a rare, potentially lethal syndrome known to be related to the initiation of dopamine antagonist medications or rapid withdrawal of dopaminergic medications. It is a diagnosis of exclusion with a known sequela of symptoms, but not all patients experience these characteristic symptoms making it difficult at times to diagnose and treat. Herein, we present a unique case of NMS with unclear etiology and a unique clinical course. Read More

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Neuroleptic Malignant Syndrome: Can Be an Unrecognized Chronic Fatal Disease.

Innov Clin Neurosci 2020 Oct-Dec;17(10-12):35-37. Epub 2020 Oct 1.

Dr. Buttar is with the Buffalo Psychiatric Center in Buffalo New York.

This case report concentrates on the fatal consequences of the chronic aspects of neuroleptic malignant syndrome (NMS). It is a life-threatening side effect and has been identified since antipsychotics were developed. Efforts to highlight the propensity to develop NMS for those more sensitive to psychotropic medications have been infrequent. Read More

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October 2020

Movement Disorder Emergencies.

Neurol Clin 2021 05 31;39(2):615-630. Epub 2021 Mar 31.

Division of Neurology, Lahey Hospital and Medical Center, Burlington, MA 01805, USA; Department of Neurology, Tufts University School of Medicine, Boston, MA 02111, USA. Electronic address:

Acute presentation of new movement disorders and acute decompensation of chronic movement disorders are uncommon but potentially life-threatening. Inadvertent or purposeful overdose of many psychiatric medications can result in acute life-threatening movement disorders including serotonin syndrome, neuroleptic malignant syndrome, and malignant catatonia. Early withdrawal of potentiating medications, treatment with benzodiazepines and other diagnosis-specific drugs, and providing appropriate supportive care including airway and breathing management, hemodynamic stabilization, fluid resuscitation, and renal support including possible hemodialysis are the mainstays of acute management. Read More

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Current strategies for predicting side effects from second generation antipsychotics in youth.

Expert Opin Drug Metab Toxicol 2021 May 2:1-10. Epub 2021 May 2.

Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA.

: Antipsychotic medications are used to treat a number of conditions in children and adolescents. While side effect profiles from second generation antipsychotics (SGAs) may differ from older antipsychotics, they do not come without risk. Knowing which children may be at higher risk for specific outcomes is important clinical information for prescribers. Read More

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Malignant catatonia - sepsis or psychiatric emergency.

Am J Med 2021 Mar 31. Epub 2021 Mar 31.

Department of Internal Medicine, Baylor College of Medicine, Houston, TX.

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Crippling Side Effects Induced by Paliperidone Palmitate Treatment: A Case Report.

Cureus 2021 Feb 27;13(2):e13588. Epub 2021 Feb 27.

Behavioural Medicine, Sultan Qaboos University Hospital, Muscat, OMN.

In this report, we present the case of a 20-year-old woman with schizophrenia, who had been treated with a once-monthly dosage of long-acting paliperidone palmitate due to poor adherence to oral antipsychotics. She presented to the emergency department of the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, with tachycardia, difficulty in breathing, difficulty in swallowing, choking, excessive production of saliva, drooling, urinary incontinence, blurry vision, a shuffling gait, slowness of movement, stooped posture, muscle rigidity, tremor, and hyperprolactinemia. The paliperidone palmitate injections were discontinued and the patient underwent a treatment course with procyclidine, and she subsequently achieved full recovery within seven days. Read More

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February 2021

Neuroleptic Malignant Syndrome After Re-introduction of Atypical Antipsychotics in a COVID-19 Patient.

Cureus 2021 Feb 18;13(2):e13428. Epub 2021 Feb 18.

Medical Critical Care, Boston Children's Hospital, Boston, USA.

We present a case of neuroleptic malignant syndrome (NMS) in a 46-year-old white female from a state psychiatric hospital who also tested positive for coronavirus-2019 (COVID-19) (severe acute respiratory syndrome coronavirus, SARS-CoV-2) infection after re-introduction of her home antipsychotics medication. She presented with confusion and altered mental status likely secondary to delirium from COVID-19 infection. Clozapine and risperidone were initially held on admission and restarted after continuing agitation on day two. Read More

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February 2021

Case Report: Ziprasidone induced neuroleptic malignant syndrome.

F1000Res 2021 17;10:124. Epub 2021 Feb 17.

Department of Critical Care Medicine, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Bagmati, Nepal.

Neuroleptic malignant syndrome (NMS) is a well-recognized neurologic emergency. It presents with classic features including hyperthermia, autonomic instability, muscle hypertonia, and mental status changes. The syndrome is potentially fatal and is associated with significant morbidity due to complications such as rhabdomyolysis, acute kidney injury, and ventricular arrhythmias due to the trans-cellular electrolyte shift. Read More

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February 2021

Ziprasidone Associated Neuroleptic Malignant Syndrome.

Kans J Med 2021 19;14:82-83. Epub 2021 Mar 19.

Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS.

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Neuroleptic malignant syndrome associated with long-acting injectable versus oral second-generation antipsychotics: Analyses based on a spontaneous reporting system database in Japan.

Schizophr Res 2021 Mar 19;231:42-46. Epub 2021 Mar 19.

Yamanashi Prefectural Kita Hospital, 3314-13 Kamijouminamiwari, Nirasaki, Yamanashi 407-0046, Japan; Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan; Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada.

Long-acting injectable antipsychotics (LAI-APs) remain underutilized. One reason is the concern that LAI-APs might cause serious adverse events such as neuroleptic malignant syndrome (NMS) and lead to prolonged symptoms compared with oral treatment. Because the risk of NMS associated with LAI second-generation antipsychotics (LAI-SGAs) remains unclear, we compared reporting frequency, time to onset, and mortality of NMS between LAI- and oral SGAs using data from a Japanese spontaneous adverse event reporting database between April 2004 and September 2019. Read More

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Neurological Consequences of SARS-CoV-2 Infection and Concurrence of Treatment-Induced Neuropsychiatric Adverse Events in COVID-19 Patients: Navigating the Uncharted.

Front Mol Biosci 2021 18;8:627723. Epub 2021 Feb 18.

Drug Discovery and Development Centre (H3D), University of Cape Town, Rondebosch, South Africa.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to the angiotensin-converting enzyme 2 (ACE2) receptor and invade the human cells to cause COVID-19-related pneumonia. Despite an emphasis on respiratory complications, the evidence of neurological manifestations of SARS-CoV-2 infection is rapidly growing, which is substantially contributing to morbidity and mortality. The neurological disorders associated with COVID-19 may have several pathophysiological underpinnings, which are yet to be explored. Read More

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February 2021

Rhabdomyolysis secondary to severe tic fits.

BMJ Case Rep 2021 Mar 2;14(3). Epub 2021 Mar 2.

Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA

Tourette syndrome (TS) is a condition wherein motor and vocal tics occur, provoked by an urge, but often not able to be completely voluntarily controlled. Tics are known to cause physical and emotional risks to quality of life, and in rare extreme cases, may have permanent consequences. We report the first cases, to our knowledge, of rhabdomyolysis due to extreme tic fits in two distinct patients with TS. Read More

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Neuroleptic malignant syndrome following COVID-19 vaccination.

Am J Emerg Med 2021 Feb 20. Epub 2021 Feb 20.

Ahmadi Hospital of Kuwait Oil Company, Kuwait City, Kuwait.

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February 2021

Levosulpiride associated neuroleptic malignant syndrome in an elderly patient: a tale of confusing brand names.

Acta Neurol Belg 2021 Feb 20. Epub 2021 Feb 20.

Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

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February 2021

Successful Emergency Treatment of Refractory Neuroleptic Malignant Syndrome With Electroconvulsive Therapy and a Novel Use of Dexmedetomidine: A Case Report From California in the Era of COVID-19.

J ECT 2021 03;37(1):71-73

Department of Psychiatry, Kaiser Permanente, Walnut Creek, CA.

Abstract: We describe the case of a patient, hospitalized in a California community medical ICU for over a month, with severe neuroleptic malignant syndrome (NMS), unresponsive to medical management, but responsive to electroconvulsive therapy (ECT). We discuss the medical, logistical, and legal challenges in providing ECT in this setting. We also describe a previously unpublished use of dexmedetomidine, which aided in the safe and rapid reduction of benzodiazepines and permitted a successful ECT course. Read More

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Atypical Neuroleptic Malignant Syndrome in the Setting of Quetiapine Overdose: A Case Report and Review of the Literature.

Cureus 2021 Jan 10;13(1):e12602. Epub 2021 Jan 10.

Department of Internal Medicine, Southeast Health, Dothan, USA.

Neuroleptic malignant syndrome (NMS) is a rare and life-threatening emergency. The condition is largely iatrogenic and is often precipitated by medications such as antipsychotics. First-generation antipsychotics are more likely to cause NMS than second-generation antipsychotics. Read More

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January 2021

Subcortical Structure Disruption in Diffusion Tensor Tractography of the Patient With the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity Combined With Neuroleptic Malignant Syndrome: A Case Report.

Clin Neuropharmacol 2021 Mar-Apr 01;44(2):62-67

Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea.

Background: Lithium can cause not only acute neurotoxicity but also chronic and persistent neurotoxicity known as syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). The combined use of lithium and antipsychotics increases the possibility of SILENT. Neuroleptic malignant syndrome (NMS) is a reversible, idiosyncratic, and potentially life-threatening reaction, which is usually caused by antipsychotics and other agents, such as mood stabilizers (eg, lithium and metoclopramide). Read More

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February 2021

Beneficial effects of dantrolene in the treatment of rhabdomyolysis as a potential late complication associated with COVID-19: a case report.

Eur J Med Res 2021 Feb 8;26(1):18. Epub 2021 Feb 8.

Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-Ku, Tokyo, 173-8610, Japan.

Background: Patients with severe COVID-19 have disorders of the respiratory, cardiovascular, coagulation, skeletal muscle, and central nervous systems. These systemic failures may be associated with cytokine release syndrome, characterized by hyperpyrexia, thrombocytopenia, hyperferritinemia, and the elevation of other inflammatory markers. Rhabdomyolysis with high fever is a complication that is rarely found in COVID-19. Read More

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February 2021

Development of Neuroleptic Malignant Syndrome in a Patient with Lewy Body Dementia after Intramuscular Administration of Paliperidone.

Case Rep Neurol Med 2021 13;2021:8879333. Epub 2021 Jan 13.

Department of Neurology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

Neuroleptic malignant syndrome (NMS) is a potentially fatal diagnosis composed of hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability. This syndrome has significant systemic complications including acute renal failure, rhabdomyolysis, hyperkalemia, and seizure. It is associated with the use of both typical and atypical antipsychotics. Read More

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January 2021

Drug-induced Hyperthermic Syndromes in Psychiatry.

Clin Psychopharmacol Neurosci 2021 Feb;19(1):1-11

Malignant Hyperthermia Association of the United States, Sherburne, NY, USA.

Hyperthermia, or extreme elevations in body temperature, can be life-threatening and may be caused by prescription drugs or illegal substances acting at a number of different levels of the neuraxis. Several psychotropic drug classes and combinations have been associated with a classic clinical syndrome of hyperthermia, skeletal muscle hyper-metabolism, rigidity or rhabdomyolysis, autonomic dysfunction and altered mental status ranging from catatonic stupor to coma. It is critical for clinicians to have a high index of suspicion for these relatively uncommon drug-induced adverse effects and to become familiar with their management to prevent serious morbidity and mortality. Read More

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February 2021

Dose-dependent effects of antipsychotics on efficacy and adverse effects in schizophrenia.

Behav Brain Res 2021 Mar 5;402:113098. Epub 2021 Jan 5.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada. Electronic address:

Background: Antipsychotics are a cornerstone of pharmacological treatment of schizophrenia. Improved understanding of the dose-response relationship of antipsychotics in terms of efficacy, adverse effects, and mortality can help to optimize the pharmacological treatment of schizophrenia.

Methods: This narrative literature review summarizes current evidence on the relationship of antipsychotic dose with efficacy, adverse effects, and mortality in patients with schizophrenia. Read More

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Creatine kinase elevation and discontinuation of clozapine: fear-driven clinical practice in a forensic case with treatment-resistant schizophrenia and persistent violent behaviour.

BJPsych Open 2020 Dec 4;7(1):e4. Epub 2020 Dec 4.

Community Psychiatry Heerhugowaard, Mental Health Organization North-Holland North, The Netherlands.

In forensic settings, the most common indication for clozapine is treatment-resistant schizophrenia (TRS). Clozapine has also been shown to be effective in reducing hostility, aggression and violence in patients with schizophrenia and is of benefit in comorbid substance use disorders. The decision to initiate or to discontinue recently initiated clozapine can have a profound beneficial or detrimental influence on the lives and safety of patients and the staff caring for them. Read More

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December 2020

[Neuroleptic malignant syndrome treated with electroconvulsive therapy].

Ugeskr Laeger 2020 Nov;182(48)

Neuroleptic malignant syndrome (NMS) is a rare but severe complication to antipsychotic treatment. Both first-generation and second-generation antipsychotics can induce NMS. This is a case report of NMS induced by second-generation antipsychotic treatment with aripiprazole causing symptoms of rigidity, altered mental status, diaphoresis and creatine kinase elevation. Read More

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November 2020

HyperCKemia and rhabdomyolysis in the neuroleptic malignant and serotonin syndromes: A literature review.

Neuromuscul Disord 2020 12 31;30(12):949-958. Epub 2020 Oct 31.

Department of Neurology, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC Nijmegen, the Netherlands.

Neuroleptic malignant syndrome and serotonin syndrome are two syndromes whose molecular bases remain poorly understood. The phenotypes of both syndromes overlap with other syndromes that have a clear genetic background, in particular RYR1-related malignant hyperthermia. Through a literature review, performed according to the PRISMA guidelines, we aimed to report the clinical features of both syndromes, and the results of genetic testing performed. Read More

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December 2020