Key result
A 17-year-old male developed severe neuroleptic malignant syndrome requiring ICU care after only 2 days of olanzapine and 1 day of divalproex sodium treatment.
Case Report (n=1)
Atypical antipsychotics such as olanzapine can cause neuroleptic malignant syndrome in adolescents even after very brief exposure.
Rapid NMS onset possible after brief olanzapine plus divalproex in adolescents; hypothesis-generating for combined-agent risk and monitoring needs.
A 17-year-old African-American male developed neuroleptic malignant syndrome (NMS) with hyperthermia, autonomic instability, increased muscle tone, rhabdomyolysis, and obtundation after a maximum of 2 days of treatment with olanzapine and 1 day of treatment with divalproex sodium. Intensive care unit (ICU)-level care was required. Paranoid psychosis with catatonia was present after recovery from the NMS. Because of his continued psychotic symptoms following resolution of the NMS, the alternate atypical antipsychotic, clozapine, was started under close observation. Reports of NMS resulting from atypical antipsychotic agents are generally uncommon, and much more so in the child and adolescent population. However, these agents are frequently prescribed in this population and require due caution.
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Hanft et al. (2004) conducted a case report in Neuroleptic malignant syndrome (n=1). Olanzapine and divalproex sodium was evaluated on Neuroleptic malignant syndrome. A 17-year-old male developed severe neuroleptic malignant syndrome requiring ICU care after only 2 days of olanzapine and 1 day of divalproex sodium treatment.
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