Atypical neuroleptic malignant syndrome in patients treated with aripiprazole and clozapine: a case-series study and short review.
Int J Psychiatry Med
; 49(1): 35-43, 2015.
Article
em En
| MEDLINE
| ID: mdl-25838319
ABSTRACT
OBJECTIVES:
Neuroleptic malignant syndrome (NMS) requires emergency treatment and can be fatal. Combined aripiprazole and clozapine therapy is rarely used in clinical settings, and NMS related this combination still lacks evaluation. Herein, we present two cases of atypical NMS treated with aripiprazole and clozapine.METHODS:
Case 1 was a schizophrenic male with a history of NMS under treatment with aripiprazole 20 mg. He was hospitalized and maintained with aripiprazole 5 mg and clozapine 225 mg. On the 25th day, atypical NMS occurred with rigidity, elevated creatine kinase, and stupor, which subsided with supportive therapy. He was discharged under treatment with aripiprazole 15 mg and fluoxetine 60 mg. Case 2 was a female with schizoaffective disorder without a history of NMS. She was hospitalized and maintained with clozapine 50 mg and aripirazole 30 mg. On the 11th day, atypical NMS occurred with mild fever, delirium, and rigidity, which subsided under supportive therapy. RESULTS ANDCONCLUSIONS:
Our cases highlight the atypical features of NMS in patients being treated with combined ari-piprazole and clozapine. Consciousness change, modest elevation of creatine kinase, and leukocytosis were the most consistent findings; hyperthermia accounts for only some of the cases. This is a reminder of the importance of earlier detection of the soft signs and atypical features of NMS under this combined treatment.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Piperazinas
/
Transtornos Psicóticos
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Esquizofrenia
/
Psicologia do Esquizofrênico
/
Clozapina
/
Quinolonas
/
Síndrome Maligna Neuroléptica
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Int J Psychiatry Med
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Taiwan