Hyponatremia, Convulsions and Neuroleptic Malignant Syndrome in a Male with Schizoaffective Disorder

Looi, Jeffrey Cl; Cubis, Jeffrey; Saboisky, John

doi:10.3109/00048679509064986

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…16 Indeed, in a 6-year follow-up of 274 elderly participants (36 with diabetes and 238 without diabetes), Hassing et al 17 found type 2 diabetes to be associated with accelerated cognitive decline in old age that may result in dementia. It seems that type-2 diabetes is an independent risk factor for cognitive decline and dementia.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The elevation of creatine kinase was nonspecific and does not confirm the diagnosis of NMS. 1,2,17,18 It follows that patients who sustain basal ganglia damage associated with EPM after hyponatremia and who are also receiving SGAs could be at increased risk of developing NMS. 4,5 She received quetiapine for 2 years without incident and previously received more potent antipsychotics without NMS.…”

Section: Discussionmentioning

confidence: 99%

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Lisinopril May Augment Antidepressant Response

Hertzman¹,

Adler²,

Arling³

et al. 2005

Journal of Clinical Psychopharmacology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lisinopril May Augment Antidepressant Response

Hertzman¹,

Adler²,

Arling³

et al. 2005

Journal of Clinical Psychopharmacology

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“…(100) on December 21, 2021 by guest. Protected by copyright.http://bmjopen.bmj.com/ BMJ Open: first published as 10.1136/bmjopen-2020-046539 on 9 December 2021.…”

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confidence: 99%

Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review

et al. 2021

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IntroductionExcessive water intake is rarely associated with life-threatening hyponatraemia. The aim of this study was to determine the clinical characteristics and outcomes of hyponatraemia associated with excess water intake.MethodsThis review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies (case reports, observational or interventional studies) reporting excess water intake and hyponatraemia in adults (1946–2019) were included.ResultsA total of 2970 articles were identified and 177 were included (88.7% case reports), consisting of 590 patients. The mean age was 46±16 years (95% CI 44 to 48 years), 47% female, 52% had a chronic psychiatric disorder and 31% had no underlying condition. The median volume of water consumed and serum sodium at presentation was 8 L/day (95% CI 8.9 to 12.2 L/day) and 118 mmol/L (95% CI 116 to 118 mmol/L), respectively. The motivator for increased water consumption was psychogenic polydipsia (55%); iatrogenic (13%); exercise (12%); habitual/dipsogenic polydipsia (7%) and other reasons (13%). The clinical features on presentation were severe in 53% (seizures, coma); moderate in 35% (confusion, vomiting, agitation) and mild in 5% (dizziness, lethargy, cognitive deficit) and not reported in 5% of studies. Treatment was supportive in 41% of studies (fluid restriction, treatment of the underlying cause, emergency care), and isotonic and hypertonic saline was used in 18% and 28% of cases, respectively. Treatment-related complications included osmotic demyelination (3%) and rhabdomyolysis (7%), and death occurred in 13% of cases.ConclusionWater intoxication is associated with significant morbidity and mortality and requires daily intake to substantially exceed population-based recommendations. The limitations of this analysis are the low quality and high risk of bias of the included studies.PROSPERO registration numberA pre-existing protocol in the international prospective register of systematic reviews was updated to incorporate any new amendments and reregistered at http://www.crd.york.ac.uk/PROSPERO (registration no. CRD42019129809).

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“…Water intoxication is often complicated with hyponatremia and hypo osmotic pressure, and is reported to be associated with SIADH (11). There are few case reports showing complication of NMS and water intoxication (5,(12)(13)(14)(15)(16)(17). Moreover, rhabdomyolysis is sometimes complicated together with both NMS and water intoxication (12,14,18).…”

Section: Discussionmentioning

confidence: 99%

Case Report: A Patient With Neuroleptic Malignant Syndrome, Water Intoxication and Hyponatremia Associated With Severe Cerebral Edema and Coma

et al. 2022

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BackgroundWater intoxication is typically caused by primary or psychogenic polydipsia that potentially may lead to fatal disturbance in brain functions. Neuroleptic malignant syndrome (NMS) is a serious complication induced by administration of antipsychotics and other psychotropic drugs. The combination of inappropriate secretion of antidiuretic hormone (SIDAH), NMS and rhabdomyolysis have been rarely reported. Our patient also developed severe water intoxication.Case presentationHerein we report a comatose case of NMS complicated with water intoxication, syndrome of SIADH and rhabdomyolysis. This patient had severe cerebral edema and hyponatremia that were improved rapidly by the correction of hyponatremia within a couple of days.ConclusionsMalignant neuroleptic syndrome water intoxication, SIADH and rhabdomyolysis can occur simultaneously. Comatose conditions induced by cerebral edema and hyponatremia can be successfully treated by meticulous fluid management and the correction of hyponatremia.

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Hyponatremia, Convulsions and Neuroleptic Malignant Syndrome in a Male with Schizoaffective Disorder

Abstract: Hyponatremia and NMS have been found to be associated. This association may be due to an undefined common pathogenesis, or may be coincidental. Hyponatremia may also hinder the diagnosis of NMS.

Cited by 12 publications

References 21 publications

Lisinopril May Augment Antidepressant Response

Lisinopril May Augment Antidepressant Response

Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review

Case Report: A Patient With Neuroleptic Malignant Syndrome, Water Intoxication and Hyponatremia Associated With Severe Cerebral Edema and Coma

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