Case Study: Neuroleptic-Induced Catatonia as a Stage in the Progression toward Neuroleptic Malignant Syndrome

Woodbury, Margarita M.; Woodbury, Michael

doi:10.1097/00004583-199211000-00028

Cited by 129 publications

(62 citation statements)

References 22 publications

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“…8 In addition, neuroleptic malignant syndrome (NMS) has been discussed in terms of the relationship to lethal catatonia. 9,10 From the historical point of view as mentioned in the previous section, four different disorders (organic, psychotic, mood, and toxic) are able to manifest in catatonic features. Although these four disorders appear not only in adulthood but also in childhood and adolescence, child and adolescent catatonia has been poorly investigated.…”

Section: Introductionmentioning

confidence: 99%

Catatonia in childhood and adolescence

Takaoka

Takata

2003

Psychiatry Clin Neurosci

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Child and adolescent catatonia has been poorly investigated. A literature review was undertaken to clarify phenomenology, diagnosis, etiology, and treatment as well as ethical problems of catatonia in childhood and adolescence. Although there are no accepted standardized criteria for catatonia in childhood and adolescence, catatonic features described by child psychiatrists are similar to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for catatonia. With respect to etiology, the motor and behavioral symptoms that are part of catatonia bear some similarities with those seen in autism. Several case reports suggest an association between catatonia and general medical conditions. Certain drugs abused by youngsters as well as prescribed medicine can induce catatonia. Regarding catatonic cases originally diagnosed as schizophrenia, it is unclear whether all of these cases should be identified as schizophrenia or whether some of them are pervasive developmental disorders that develop psychic features in adolescence. Environmental changes preceding the onset of catatonia in patients with mood disorder play a possibly important role. Examples that suggest stress-induced catatonia, although rare, also exist. A few patients exhibit features of malignant catatonia, some without taking neuroleptics and others having taken them. Benzodiazepines and electroconvulsive therapy are considered to be effective treatments for catatonic youngsters.

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Section: Introductionmentioning

confidence: 99%

Catatonia in childhood and adolescence

Takaoka

Takata

2003

Psychiatry Clin Neurosci

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“…Bromocriptine (2.55 mg 8 hourly per orally or by nasogastric tube) has been listed under 1st line inter vention for the treatment of moderate to severe NMS spectrumrelated symptoms. 19 It has been recommended that bromocriptine should be instituted with a starting dose of 2.5 mg 2 to 3 times a day, which can be increased to a total daily dose of 45 mg if needed. 6 In view of the severity of NMS on the very first day, we had started with bromocriptine 10 mg bid which is a relatively higher than recommended starting dose for bromocriptine and increased it to 10 mg tid on the 2nd day.…”

Section: 9mentioning

confidence: 99%

Successful Treatment of a Complicated Case of Neuroleptic Malignant Syndrome with a Higher Dose of Bromocriptine and Lorazepam

Kashyap¹,

Sharma²

2015

Journal of Postgraduate Medicine, Education and Research

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A 53-year-old patient of schizoaffective disorder developed neuroleptic malignant syndrome (NMS) following treatment with haloperidol, clozapine and parenteral fluphenazine. He showed full recovery with immediate discontinuation of potential offenders and prompt treatment with a higher dose of bromocriptine and lorazepam along with management of aspiration pneumonia. Need for early recognition of NMS and treatment by a multidisciplinary team is discussed.

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“…The typical progression of symptoms of NMS from the mildest stage I (drug-induced parkinsonism) through stage V or the severest form of NMS (Odagaki, 2009). Stages I-V are originally proposed by Woodbury and Woodbury (1992) and adapted by Strawn et al (2007).…”

Section: Clinical Course and Outcomementioning

confidence: 99%

“…Still controversial, but may be useful in mild or early cases to help attenuate EPS (Woodbury and Woodbury, 1992) …”

Section: Treatment With Comments Anticholinergicsmentioning

confidence: 99%