lithium-chloride and Neuroleptic-Malignant-Syndrome

Topics: Adult; Humans; Lithium Chloride; Male; Neuroleptic Malignant Syndrome; Risperidone

This report describes the presentation of neuroleptic malignant syndrome (NMS) in the primary care setting in an older adult with major depression with psychosis. This patient had been stable on a regimen of amoxapine, lithium carbonate, lorazepam, and benztropine. The patient had rigidity, altered sensorium, diaphoresis, autonomic instability, elevated WBC count and urine myoglobin, and creatine phosphokinase (CPK) reaching 1331 U/I. He was successfully treated with bromocriptine.

Topics: Amoxapine; Antidepressive Agents, Second-Generation; Antimanic Agents; Depressive Disorder; Humans; Lithium Chloride; Male; Middle Aged; Neuroleptic Malignant Syndrome; Psychotic Disorders

Neuroleptic Malignant Syndrome (NMS) is a life-threatening adverse reaction arising from the use of neuroleptic medications. While dopaminergic agonists, dantrolrene and supportive care are traditionally utilized in the stabilization and management of NMS, anticholinergic medication may also prove effective therapy. Treatment with anticholinergic medication has been suggested in cases of NMS associated with mild hyperthermia. We describe a case of 17-y-old female, who was brought to the emergency department for a possible "acute dystonic reaction". The patient received 50 mg diphenhydramine i.v., which resulted in improvement in mental status. The patient was readmitted to the emergency department 1 d following discharge with symptoms similar, but now considering the diagnosis of NMS. Diphenhydramine 50 mg i.v. was again administered and resulted in significant improvement.

Topics: Adolescent; Benztropine; Cholinergic Antagonists; Diphenhydramine; Female; Fever; Fluphenazine; Humans; Lithium Chloride; Neuroleptic Malignant Syndrome

Topics: Antimanic Agents; Drug Interactions; Humans; Lithium Chloride; Neuroleptic Malignant Syndrome; Paroxetine; Risperidone; Selective Serotonin Reuptake Inhibitors; Serotonin Antagonists