Key result
Administration of typical and atypical antipsychotics for delirium in a postoperative cardiac surgery patient resulted in neuroleptic malignant syndrome that resolved with dantrolene and fluid therapy.
Case Report (n=1)
Prompt discontinuation of antipsychotics and initiation of dantrolene can resolve neuroleptic malignant syndrome in postoperative cardiac surgery patients.
Alerts to NMS risk with antipsychotics for post-cardiac surgery delirium; leaves open optimal prevention and management strategies.
We report a case of neuroleptic malignant syndrome (NMS) in a postoperative cardiac surgery patient after the administration of typical and atypical antipsychotics for the treatment of delirium. On postoperative day 8, the patient's temperature peaked at 40.6°C. Agitation, rigidity, elevation in creatine kinase, and leukocytosis were associated findings. NMS was suspected on postoperative day 10. All antipsychotics were discontinued; dantrolene infusions and fluid therapy were initiated. After 2 days of NMS treatment, the patient's symptoms resolved. The temporal relationship between discontinuation of all antipsychotics, initiation of dantrolene, and clinical improvement supports the diagnosis of antipsychotic-induced NMS.
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Moll et al. (2016) conducted a case report in Neuroleptic malignant syndrome (n=1). Typical and atypical antipsychotics was evaluated on Development and resolution of neuroleptic malignant syndrome. Administration of typical and atypical antipsychotics for delirium in a postoperative cardiac surgery patient resulted in neuroleptic malignant syndrome that resolved with dantrolene and fluid therapy.
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