piperidines and Neuroleptic-Malignant-Syndrome

Topics: Aged; Cisapride; Humans; Male; Neuroleptic Malignant Syndrome; Piperidines; Serotonin Antagonists

New publications on malignant hyperthermia (MH), with direct clinical importance, are reported. Since even in the recent past patients have died from MH in spite of therapy with dantrolene, the effectiveness of dantrolene is discussed in particular. Atypical clinical pictures of MH are presented. Special psychiatric syndromes (malignant neuroleptic syndrome and acute febrile catatonia), rhabdomyolysis with myoglobinuria following strenuous exercise or exposure to heat are mentioned, as these disorders appear to be related to MH, in that they are hypermetabolic syndromes implying a muscle membrane dysfunction. The role of slow calcium channel blockers and 5-hydroxytryptamine antagonists as prophylactic or therapeutic agents in MH is discussed. A schedule describing how to diagnose, treat and prevent MH, considering recent advances, is presented.

Topics: Anesthesia; Animals; Calcium Channel Blockers; Catatonia; Dantrolene; Diagnosis, Differential; Humans; Ketanserin; Malignant Hyperthermia; Neuroleptic Malignant Syndrome; Piperidines; Serotonin Antagonists; Swine

Topics: Cholinesterase Inhibitors; Donepezil; Humans; Indans; Neuroleptic Malignant Syndrome; Piperidines; Rhabdomyolysis

Topics: Adult; Female; Humans; Neuroleptic Malignant Syndrome; Piperazines; Piperidines

A 78-year-old man with a 22-year history of schizoaffective disorder and a 5-year history of dementia presented to the emergency department with a 5-day history of fatigue, progressive weakness, confusion and lethargy, and a 1-day history of severe muscle stiffness. For the past 10 years the patient had been treated with olanzapine for an unspecified psychiatric illness, without adverse effects. One week before presentation the patient was started on donepezil to treat mild dementia.. Physical examination, serum and urine laboratory evaluation, lumbar puncture, brain CT scan, brain MRI, electroencephalogram, chest X-ray, and electrocardiogram.. A variant of neuroleptic malignant syndrome secondary to drug interaction.. Discontinuation of donepezil and olanzapine, aggressive intravenous hydration, intravenous dantrolene, and bromocriptine via a nasogastric tube. The patient was also administered intravenous antibiotics for aspiration pneumonia, and carbidopa-levodopa for residual parkinsonian features.

Topics: Aged; Benzodiazepines; Cholinesterase Inhibitors; Donepezil; Humans; Indans; Male; Neuroleptic Malignant Syndrome; Olanzapine; Piperidines; Selective Serotonin Reuptake Inhibitors

Topics: Aged; Anti-Anxiety Agents; Antipsychotic Agents; Benzodiazepines; Catatonia; Chlorpromazine; Cholinesterase Inhibitors; Cognition Disorders; Creatine Kinase; Dementia; Disease Progression; Donepezil; Female; Humans; Indans; Lorazepam; Muscle Rigidity; Neuroleptic Malignant Syndrome; Olanzapine; Piperidines; Recurrence; Risperidone

Topics: Aged; Cholinesterase Inhibitors; Donepezil; Female; Humans; Indans; Lewy Body Disease; Neuroleptic Malignant Syndrome; Piperidines

Topics: Aged; Alzheimer Disease; Antidepressive Agents, Second-Generation; Cholinesterase Inhibitors; Donepezil; Drug Synergism; Humans; Indans; Male; Maprotiline; Neuroleptic Malignant Syndrome; Piperidines

The patient was a 68-year-old man with a 1-year history of delusions related to well-formed and detailed visual hallucinations. Bromperidol 12 mg was prescribed to treat his symptoms. After a diagnosis of dementia of Alzheimer's type was suspected, the patient received donepezil hydrochloride 5 mg. One week later, the patient's Parkinsonism deteriorated. One month later, the patient developed radical edema of the eyelids and the anterior neck, hypoproteinemia, and severe anteflexion of the body. One and a half months later, the patient developed malignant syndrome. His medication was discontinued and parenteral nutrition was started. The patient recovered from his malignant syndrome. However, 1 month later, his Parkinsonism had not improved. The patient received levodopa to treat his Parkinsonism and his symptoms subsequently improved. The hallucinations and systematized delusions returned. The patient's cognitive impairment deteriorated on one side. The aggravation of extrapyramidal symptoms and the development of malignant syndrome were believed to have been caused by the combination of bromperidol and donepezil hydrochloride and poor nutrition. Caution should be exercised when prescribing an antipsychotic drugs with donepezil hydrochloride.

Topics: Aged; Donepezil; Drug Therapy, Combination; Hallucinations; Haloperidol; Humans; Indans; Lewy Body Disease; Male; Neuroleptic Malignant Syndrome; Nootropic Agents; Piperidines

Topics: Antipsychotic Agents; Confusion; Creatine Kinase; Drug Therapy, Combination; Fever; Humans; Isoxazoles; Lithium Carbonate; Neuroleptic Malignant Syndrome; Piperidines; Risperidone; Schizophrenia

Topics: Adult; Antipsychotic Agents; Female; Humans; Isoxazoles; Neuroleptic Malignant Syndrome; Piperidines; Primidone; Psychotic Disorders; Risperidone; Tremor

Topics: Aged; Antipsychotic Agents; Humans; Isoxazoles; Male; Neuroleptic Malignant Syndrome; Piperidines; Risperidone; Schizophrenia, Paranoid

Topics: Antipsychotic Agents; Bipolar Disorder; Humans; Isoxazoles; Male; Middle Aged; Neuroleptic Malignant Syndrome; Piperidines; Risperidone; Treatment Outcome

Topics: Aged; Apnea; Brain; Cisapride; Fatal Outcome; Humans; Hyperventilation; Male; Metoclopramide; Neuroleptic Malignant Syndrome; Piperidines

Topics: Aged; Aged, 80 and over; Antipsychotic Agents; Female; Humans; Isoxazoles; Male; Neuroleptic Malignant Syndrome; Piperidines; Risperidone

Topics: Adult; Antipsychotic Agents; Haloperidol; Humans; Isoxazoles; Male; Neuroleptic Malignant Syndrome; Piperidines; Risperidone

1. The authors describe a case report of catatonia syndrome after administration of depot neuroleptics. 2. Differential diagnosis was made between neuroleptic malignant syndrome or catatonic syndrome complicated by infection. The signs and symptoms observed throughout the patient's course are detailed. 3. A critical review is made of bibliography on the topic, with emphasis on the lack of clear clinical description and poor conceptual definition.

Topics: Adult; Antipsychotic Agents; Biperiden; Catatonia; Delayed-Action Preparations; Diagnosis, Differential; Humans; Male; Neuroleptic Malignant Syndrome; Phenothiazines; Piperidines; Schizoid Personality Disorder; Syndrome; Thiazines

Topics: Adult; Antidepressive Agents; Antipsychotic Agents; Bipolar Disorder; Female; Humans; Imipramine; Male; Neuroleptic Malignant Syndrome; Penfluridol; Piperidines; Schizophrenia

Topics: Aged; Drug Interactions; Female; Humans; Middle Aged; Neuroleptic Malignant Syndrome; Penfluridol; Piperidines; Sulpiride

In a schizophrenic patient, hypothermia was caused by combined treatment with zotepine, biperiden, and fluphenazine, although combined treatment with zotepine and biperiden had caused no side effects. Other side effects closely resembled those in neuroleptic malignant syndrome.

Topics: Adult; Biperiden; Dibenzothiepins; Drug Therapy, Combination; Fluphenazine; Humans; Hypothermia; Male; Neuroleptic Malignant Syndrome; Piperidines; Schizophrenia

Topics: Amantadine; Bromocriptine; Cortisone; Drug Therapy, Combination; Humans; Neuroleptic Malignant Syndrome; Piperidines

Topics: Adult; Basal Ganglia Diseases; Delusions; Haloperidol; Humans; Male; Neuroleptic Malignant Syndrome; Parasympatholytics; Piperidines; Psychotic Disorders

Topics: Biperiden; Haloperidol; Humans; Male; Middle Aged; Neuroleptic Malignant Syndrome; Piperidines