Olanzapine-Induced Malignant Neuroleptic Syndrome

Sarıtaş, Tuba Berra; Çankaya, Barış; Yosunkaya, Alper

doi:10.5152/tjar.2014.46704

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…While NMS is more common in typical antipsychotics, several reports showed that atypical antipsychotics, more specifically olanzapine, can give rise to NMS. [8][9][10][11][12][13][14][15] It has also been found that NMDA receptors control the release of dopamine through direct synaptic action on dopaminergic terminals. Decreased NMDA receptors can affect dopaminergic transmission, 1,16 NMDA receptor antibodies block the NMDA receptor in the presynaptic gamma-aminobutyric acid neurons of the thalamus and frontal cortex.…”

Section: Discussionmentioning

confidence: 99%

Neuroleptic Malignant Syndrome in a Patient With Anti-N-Methyl-D-Aspartate Receptor Encephalitis: Case Report and Review of Related Literature

Sarmiento

Diestro

Antonio

et al. 2021

The Neurohospitalist

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Introduction: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe but treatable disease that presents with symptoms similar to neuroleptic malignant syndrome (NMS). Case Report: We describe a 28-year old female who initially presented with headaches, behavioral changes, anxiety, lip tremors, and rigidity of extremities. She was prescribed with olanzapine and later manifested with neuroleptic malignant syndrome symptoms such as decrease in sensorium, muscle rigidity, hyperthermia and tachycardia. Further investigation showed presence of bilateral ovarian teratoma and anti-NMDAR antibodies in her serum and cerebrospinal fluid. Symptoms resolved after intravenous high-dose methylprednisolone, bilateral oophoro-cystectomy, and intravenous immunoglobulin administration. Overlapping pathological mechanisms of anti- NMDAR encephalitis and NMS were discussed. Ten patients with anti- NMDAR encephalitis and NMS were noted in a review of literature. Prognosis was favorable and intervention ranged from supportive to methylprednisolone and intravenous immunoglobulin administration, plasma exchange and teratoma resection. Conclusion: Anti- NMDAR encephalitis patients are at risk for NMS due to antipsychotic intolerance and other interrelated pathophysiological mechanisms. The overlap between the signs and symptoms of anti-NMDAR encephalitis and NMS poses a diagnostic dilemma and warrants a careful investigation and management.

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Section: Discussionmentioning

confidence: 99%

Neuroleptic Malignant Syndrome in a Patient With Anti-N-Methyl-D-Aspartate Receptor Encephalitis: Case Report and Review of Related Literature

Sarmiento

Diestro

Antonio

et al. 2021

The Neurohospitalist

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Protrahiertes malignes neuroleptisches Syndrom nach Haloperidolgabe

Wystub

Heymel

Fritzenwanger

et al. 2017

Med Klin Intensivmed Notfmed

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Neuroleptic malignant syndrome (NMS) is a rare disorder caused by drug-induced dopamine-receptor-blockage or low dopamine concentration in the brain. It is a severe reaction to neuroleptic drugs in antipsychotic therapy. Symptoms in NMS typically consist of fever, muscle rigidity and cognitive changes; laboratory findings include elevated infectious disease markers and creatine kinase as well as signs of rhabdomyolysis. To differentiate NMS from other malignant hyperthermia syndromes identifying the offending drug and clinical history are essential. Therapy in NMS includes withdrawal of the causative medication and intensive care treatment possibly with administration of dantrolene.In this case report, we describe the clinical course of a 48 year old man who developed typical clinical symptoms and laboratory parameters of malignant hyperthermia syndrome after injection of haloperidol.

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