Neuroleptic Malignant Syndrome in an Adolescent Receiving Olanzapine‐Lithium Combination Therapy

Berry, Neeraj; Pradhan, Sapna; Sagar, Rajesh; Gupta, Suresh

doi:10.1592/phco.23.2.255.32091

Cited by 40 publications

(12 citation statements)

References 30 publications

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“…In case 4, in relation to the administration of intramuscular haloperidol, catatonia suddenly progressed to NMS with muscle rigidity, hyperpyrexia, and laboratory abnormalities. In this case, we cannot rule out the possibility that lithium played an aggravating role as previously reported (Ali et al, 2006;Berry et al, 2003).…”

Section: Discussioncontrasting

confidence: 55%

Catatonia and Neuroleptic Malignant Syndrome

Luchini¹,

Lattanzi²,

Bartolommei³

et al. 2013

Journal of Nervous &Amp; Mental Disease

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We present the history of four bipolar patients who developed neuroleptic malignant syndrome (NMS) after antipsychotic treatment, focusing on the relationship between NMS and catatonia. In all cases, the administration of antipsychotics has been suspended as soon as fever and autonomic disturbances occurred. A supportive therapy was initiated to stabilize general conditions, then every patient started electroconvulsive therapy (ECT) in combination with benzodiazepines (BDZ). The risk of complications was reduced by the quick adoption of supportive care, whereas the combination of ECT and BDZ was effective in resolving the clinical picture. These cases may provide further support to the hypothesis that catatonia and NMS are disorders pertaining to the same spectrum of illness because the onset or exacerbation of catatonic symptoms coincided with the administration of antipsychotics. Our experience confirms the efficacy and safety of ECT in combination with BDZ as treatment of NMS and residual catatonia.

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Section: Discussioncontrasting

confidence: 55%

Catatonia and Neuroleptic Malignant Syndrome

Luchini¹,

Lattanzi²,

Bartolommei³

et al. 2013

Journal of Nervous &Amp; Mental Disease

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“…However, it probably was not the initial etiology of the malignant catatonia, rather a result of treatment employing a rapidly changing regimen of conventional and atypical antipsychotics, in addition to lithium. NMS has been associated with trifluoperazine [35], trifluoperazine with lithium [36] , lithium and haloperidol [37], ziprazidone [38], ziprazidone and lithium [39], olanzapine [40], and olanzapine and lithium [41]. Regardless of the initial etiology in this case, the disease course progressed from delirium due to a several general medical conditions, to NMS and finally to malignant catatonia.…”

Section: Non-malignant Vs Malignant Catatoniamentioning

confidence: 91%

Delirious Mania and Malignant Catatonia: A Report of 3 Cases and Review

et al. 2009

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Delirious mania is often difficult to distinguish from excited catatonia. While some authors consider delirious mania a subtype of catatonia, the distinction between the two entities is important as treatment differs and effects outcome. It appears that as catatonia is described as having non-malignant and malignant states, the same division of severity may also apply to delirious mania. Non-malignant delirious mania meets the criteria for mania and delirium without an underlying medical disorder. The patients are amnestic, may lose control of bowel and bladder, but still respond to atypical antipsychotics and mood stabilizers. However, with increasing progression of the disease course and perhaps with an increasing load of catatonic features, delirious mania may convert to a malignant catatonic state (malignant delirious mania) which is worsened by antipsychotics and requires a trial of benzodiazepines and/or ECT. Three case reports are presented to illustrate the diagnostic conundrum of delirious mania and several different presentations of malignant catatonia.

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“…There is some evidence that the concomitant administration of lithium with antipsychotic agents may place patients at risk for NMS [14][15][16][17]. We assume that in our case lithium toxicity and NMS syndrome were induced by combining amisulpride with the lithium therapy.…”

Section: Commentarymentioning

confidence: 80%

“…The appearance of NMS symptoms was preceded (by one day) by an unexpected elevation of blood lithium level with clinical symptoms of lithium intoxication. We have found in the literature the descriptions of cases of NMS on new generation antipsychotics combined with lithium, but no one description of NMS following administration of amisulpride with lithium [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%