This case highlights the severe risks and management challenges of neuroleptic malignant syndrome in elderly patients with dementia, including fatal adverse reactions to bromocriptine.
Fatal bromocriptine reaction in elderly NMS cautions against dopamine agonists; leaves open evidence-based management in dementia.
An elderly patient with probable dementing illness was treated with haloperidol and trifluoperazine for control of agitation. The patient developed neuroleptic malignant syndrome characterized by cogwheel rigidity, deterioration in sensorium, hyperpyrexia, mutism, autonomic dysfunction, elevated leucocyte count and serum creatinine phosphokinase. After an initial diagnostic delay treatment with very low doses of bromocriptine resulted in hypotension followed by acute renal failure and death. Problems in the management of NMS in elderly patients with concurrent psychiatric illness and/or dementing illness are discussed.
No takes yet. Share an insight, caveat, or question.
Adityanjee et al. (1992) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: