Clozapine-Associated Neuroleptic Malignant Syndrome

Letters3 September 2002Clozapine-Associated Neuroleptic Malignant SyndromeAnne M. Baciewicz, PharmD, MBA, Rajesh Chandra, MD, and Patrick Whelan, MDAnne M. Baciewicz, PharmD, MBACase Western Reserve University, Cleveland, OH 44106Search for more papers by this author, Rajesh Chandra, MDCase Western Reserve University, Cleveland, OH 44106Search for more papers by this author, and Patrick Whelan, MDCase Western Reserve University, Cleveland, OH 44106Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clozapine has been associated with atypical presentation of neuroleptic malignant syndrome (1). We observed a patient who had atypical neuroleptic malignant syndrome related to an increased clozapine dose.A 35-year-old man with bipolar disorder and schizophrenia presented to a community hospital with a 3-day history of diarrhea, fever (temperature, 38.9 °C), tachycardia (heart rate, 150 beats/min), and hallucinations. Medications included valproate sodium and oral clozapine, 100 mg/d. The latter had been started 3 weeks before admission and the dose had been increased to 150 mg/d 2 days before presentation. Upon admission, therapy with all medications was discontinued. The patient was ...References1. Karagianis JL, Phillips LC, Hogan KP, LeDrew KK. Clozapine-associated neuroleptic malignant syndrome: two new cases and a review of the literature. Ann Pharmacother. 1999;33:623-30. [PMID: 10369628] CrossrefMedlineGoogle Scholar2. Sachdev P, Kruk J, Kneebone M, Kissane D. Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. J Clin Psychopharmacol. 1995;15:365-71. [PMID: 8830069] CrossrefMedlineGoogle Scholar3. Nopoulos P, Flaum M, Miller DD. Atypical neuroleptic malignant syndrome (NMS) with an atypical neuroleptic: clozapine-induced NMS without rigidity. Ann Clin Psychiatry. 1990;2:251-3. CrossrefGoogle Scholar4. Thornberg SA, Ereshefsky L. Neuroleptic malignant syndrome associated with clozapine monotherapy. Pharmacotherapy. 1993;13:510-4. [PMID: 8247922] MedlineGoogle Scholar5. Caroff SN, Mann SC. Neuroleptic malignant syndrome. Med Clin North Am. 1993;77:185-202. [PMID: 8093494] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Anne M. Baciewicz, PharmD, MBA; Rajesh Chandra, MD; Patrick Whelan, MDAffiliations: Case Western Reserve University, Cleveland, OH 44106 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClozapine-Induced Cardiovascular Side Effects and Autonomic Dysfunction: A Systematic ReviewMyocarditis and CardiomyopathyFever development in neuroleptic malignant syndrome during treatment with olanzapine and clozapineCharacterization and Clinical Management of Clozapine-Induced FeverNeuroleptic Malignant Syndrome: No Longer Exclusively a “Neuroleptic” PhenomenonNeuroleptic-Induced Movement Disorders: Deconstructing Extrapyramidal Symptoms 3 September 2002Volume 137, Issue 5_Part_1Page: 374KeywordsAntipsychoticsCreatine kinaseFeversHallucinationsHeart rateMusclesSodiumTachycardiaTemperatureToxicology ePublished: 3 September 2002 Issue Published: 3 September 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...