Risperidone-Induced Neuroleptic Malignant Syndrome

Bajjoka, I; Patel, Tushar; O'Sullivan, Tami L.

doi:10.1016/s0196-0644(97)70091-x

Cited by 41 publications

(17 citation statements)

References 8 publications

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“…In rats given risperidone, body temperature decreased significantly compared to controls and this effect was seen over a 21-day period without weight gain [12]. In humans, risperidone treatment has been associated with both hyperthermia [13] and hypothermia [14] and in a few cases neuroleptic malignant syndrome with extremely high fever and muscle rigidity [15]. The effect of risperidone on thermoregulation is possibly related to interactions with dopaminergic and serotoninergic receptors or other receptors in the CNS, but the specific mechanisms of how these temperature modifications affect body weight are not known.…”

Section: Introductionmentioning

confidence: 99%

Risperidone alters food intake, core body temperature, and locomotor activity in mice

Cope

Jumbo-Lucioni

et al. 2009

Physiology & Behavior

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Risperidone induces significant weight gain in female mice; however, the underlying mechanisms related to this effect are unknown. We investigated the effects of risperidone on locomotor activity, core body temperature, and uncoupling protein (UCP) and hypothalamic orexin mRNA expression. Female C57BL/6J mice were acclimated to individual housing and randomly assigned to either risperidone (4 mg/kg BW*day) or placebo (PLA). Activity and body temperature were measured over 48-hour periods twice a week for 3 weeks. Food intake and body weights were measured weekly. UCP1 (BAT), UCP3 (gastrocnemius), and orexin (hypothalamus) mRNA expressions were measured using RT-PCR. Risperidone-treated mice consumed more food (p=0.050) and gained more weight (p=0.0001) than PLA-treated mice after 3 weeks. During the initial 2-days of treatment, there was an acute effect of treatment on activity (p=0.046), but not body temperature (p=0.290). During 3 weeks of treatment, average core body temperatures were higher in risperidone-treated mice compared to controls during the light phase (p=0.0001), and tended to be higher during the dark phase (p=0.057). Risperidone-treated mice exhibited lower activity levels than controls during the dark phase (p=0.006); there were no differences in activity during the light phase (p=0.47). UCP1 (p<0.01) and UCP3 (p<0.05) mRNA expressions were greater in risperidone-treated mice compared to controls, whereas, orexin mRNA expression was lower in risperidone-treated mice (p<0.01). These results suggest that risperidone-induced weight gain in mice is a consequence of increased energy intake and reduced activity, while the elevation in body temperature may be a result of thermogenic effect of food intake and elevated UCP1, UCP3, and a reduced hypothalamic orexin expression.

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Section: Introductionmentioning

confidence: 99%

Risperidone alters food intake, core body temperature, and locomotor activity in mice

Cope

Jumbo-Lucioni

et al. 2009

Physiology & Behavior

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“…The development of the syndrome is not dose related, and may occur with therapeutic doses of neuroleptics 12 . All neuroleptics have resulted in NMS, including risperidone, which was recently marketed with potent antiserotonergic activity and less antidopaminergic properties 19 . There is no evidence of a genetically transmitted risk.…”

Section: Discussionmentioning

confidence: 99%

Hyperpyrexia in the emergency department

McGugan

2001

Emergency Medicine

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The differential diagnosis of the hyperpyrexic patient in the emergency department is extensive. It includes sepsis, heat illness including heat stroke, neuroleptic malignant syndrome, malignant hyperthermia, serotonin syndrome and thyroid storm. Each of these possible diagnoses has distinguishing features that may help to differentiate one from another. However, establishing the correct diagnosis is a challenge in the setting of the obtunded emergency patient who gives no history and where there may be limited access to any past medical or drug history. This paper presents such a case and reviews the features of the differential diagnoses and management of the hyperpyrexic patient.

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“…It was hoped that this atypical neuroleptic agent would not cause dystonia or neuroleptic malignant syndrome owing to its unique mechanism of action with attenuated antidopaminergic activity and more potent antiserotoninergic activity. 6 However, this was found to be untrue. Lithium has been known to precipitate NMS when it is used in combination with other psychotropic medication, particularly clozapine, which is mainly characterised by its low affinity to dopaminergic receptors as an atypical antipsychotic.…”

Section: Introductionmentioning

confidence: 99%

Neuroleptic Malignant Syndrome after the Addition of Lithium to Risperidone Treatment: A Case Report and Review of the Literature

Unaldi

Sayhan²,

Söğüt

et al. 2010

Hong Kong j. emerg. med.

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Neuroleptic malignant syndrome (NMS) is a rare but life-threatening complication of antipsychotic therapy. The classic features of NMS include muscular rigidity, altered mental status, autonomic instability and hyperthermia. NMS is most often associated with conventional antipsychotic usage. It has also been reported with lithium and antidepressants especially when combined with antipsychotics. Herein, we report a case involving a 35-year-old man with schizoaffective disorder in whom signs and symptoms consistent with NMS developed after lithium was added to his therapy of risperidone. A firm diagnosis of NMS was made on the basis of his history, physical, laboratory and neuroimaging findings. He was then followed up and treated in the intensive care unit with supportive care measures including aggressive cooling, intravenous fluid hydration, nutrition by nasogastric tube and therapy with bromocriptine. The patient had an uneventful clinical course and was discharged from the intensive care unit after three weeks with no complications related to the NMS. (Hong Kong j.emerg.med. 2010;17:289-292) 35 3

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Risperidone-Induced Neuroleptic Malignant Syndrome

Cited by 41 publications

References 8 publications

Risperidone alters food intake, core body temperature, and locomotor activity in mice

Risperidone alters food intake, core body temperature, and locomotor activity in mice

Hyperpyrexia in the emergency department

Neuroleptic Malignant Syndrome after the Addition of Lithium to Risperidone Treatment: A Case Report and Review of the Literature

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