Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone
Neuroleptic Malignant Syndrome (NMS) associated with the use of first-generation antipsychotics is a widely known phenomenon. This idiosyncratic reaction is less significant with the use of second-generation antipsychotics, and only a few cases in the literature exist, describing this reaction with...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2021/5584104 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832547649018920960 |
|---|---|
| author | Paras Agarwal Adanegbe Omoruyi Kiara Gascon Perai Kerenza MacDaid Andrea Burton |
| author_facet | Paras Agarwal Adanegbe Omoruyi Kiara Gascon Perai Kerenza MacDaid Andrea Burton |
| author_sort | Paras Agarwal |
| collection | DOAJ |
| description | Neuroleptic Malignant Syndrome (NMS) associated with the use of first-generation antipsychotics is a widely known phenomenon. This idiosyncratic reaction is less significant with the use of second-generation antipsychotics, and only a few cases in the literature exist, describing this reaction with clozapine use. While being titrated on clozapine, the patient developed major and minor criteria features of NMS as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5) criteria except for fever, a core symptom which created diagnostic uncertainty. Initially, clozapine was temporarily discontinued due to his deteriorating mental and physical state. A rechallenge was considered at a much lower dose, but due to a rapid increase in his creatinine kinase (CK) levels within a 12-hour timeframe, clozapine was permanently stopped. The evidence further suggests that the presentation of NMS for patients on this medication may be different to the classical presentation, and other criteria for diagnosis are suggested, which may lower the threshold for investigating NMS for patients on clozapine. |
| format | Article |
| id | doaj-art-7dfdf49c8cb54aa1aeccb38a11a5a9a1 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-7dfdf49c8cb54aa1aeccb38a11a5a9a12025-02-03T06:43:58ZengWileyCase Reports in Psychiatry2090-682X2090-68382021-01-01202110.1155/2021/55841045584104Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with PaliperidoneParas Agarwal0Adanegbe Omoruyi1Kiara Gascon Perai2Kerenza MacDaid3Andrea Burton4Department of General Medicine, Ashford & St. Peter’s Hospital, Chertsey, Surrey KT16 0PZ, UKDepartment of General Medicine, Ashford & St. Peter’s Hospital, Chertsey, Surrey KT16 0PZ, UKDepartment of General Medicine, Ashford & St. Peter’s Hospital, Chertsey, Surrey KT16 0PZ, UKDepartment of General Medicine, Ashford & St. Peter’s Hospital, Chertsey, Surrey KT16 0PZ, UKDepartment of General Medicine, Ashford & St. Peter’s Hospital, Chertsey, Surrey KT16 0PZ, UKNeuroleptic Malignant Syndrome (NMS) associated with the use of first-generation antipsychotics is a widely known phenomenon. This idiosyncratic reaction is less significant with the use of second-generation antipsychotics, and only a few cases in the literature exist, describing this reaction with clozapine use. While being titrated on clozapine, the patient developed major and minor criteria features of NMS as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5) criteria except for fever, a core symptom which created diagnostic uncertainty. Initially, clozapine was temporarily discontinued due to his deteriorating mental and physical state. A rechallenge was considered at a much lower dose, but due to a rapid increase in his creatinine kinase (CK) levels within a 12-hour timeframe, clozapine was permanently stopped. The evidence further suggests that the presentation of NMS for patients on this medication may be different to the classical presentation, and other criteria for diagnosis are suggested, which may lower the threshold for investigating NMS for patients on clozapine.http://dx.doi.org/10.1155/2021/5584104 |
| spellingShingle | Paras Agarwal Adanegbe Omoruyi Kiara Gascon Perai Kerenza MacDaid Andrea Burton Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone Case Reports in Psychiatry |
| title | Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone |
| title_full | Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone |
| title_fullStr | Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone |
| title_full_unstemmed | Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone |
| title_short | Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone |
| title_sort | neuroleptic malignant syndrome nms on clozapine with a potential atypical interaction with paliperidone |
| url | http://dx.doi.org/10.1155/2021/5584104 |
| work_keys_str_mv | AT parasagarwal neurolepticmalignantsyndromenmsonclozapinewithapotentialatypicalinteractionwithpaliperidone AT adanegbeomoruyi neurolepticmalignantsyndromenmsonclozapinewithapotentialatypicalinteractionwithpaliperidone AT kiaragasconperai neurolepticmalignantsyndromenmsonclozapinewithapotentialatypicalinteractionwithpaliperidone AT kerenzamacdaid neurolepticmalignantsyndromenmsonclozapinewithapotentialatypicalinteractionwithpaliperidone AT andreaburton neurolepticmalignantsyndromenmsonclozapinewithapotentialatypicalinteractionwithpaliperidone |