Quetiapine- And Rivastigmine-Induced Neuroleptic Malignant Syndrome in Lewy Body Dementia

Abstract

INTRODUCTION: Neuroleptic malignant syndrome (NMS) is a life threatening idiosyncratic reaction to neuroleptic medications. Quetiapine is considered a safe and common medication prescribed in patients with agitation and Lewy Body dementia (LBD). We present a case of NMS in a patient with LBD who is treated with quetiapine and rivastigmine. CASE PRESENTATION:A 66 year old man with a past medical history of LBD presents to the emergency department with a 5 day progression of altered mental status. At baseline, he is typically bed-bound but able to communicate verbally and feed independently. His LBD is managed with quetiapine and rivastigmine with recent up-titration of his quetiapine dose. His quetiapine was held 3 days prior to presentation due to concerns for sedation.