Atypical Neuroleptic Malignant Syndrome Precipitated By Clozapine And Quetiapine Overdose: A Diagnostic Challenge

CONCLUSION In conclusion, NMS is a potentially life-threatening condition with variable clinical presentation. Clinicians should have a high index of suspicion for NMS in patients on antipsychotic medications. NMS can have atypical presentations especially when precipitated by SGAs, such as clozapine and quetiapine. A diagnosis of atypical NMS should be considered even in the absence of rigidity or other classical symptoms. Serum CK should routinely be checked and trended to facilitate diagnosis in these cases. Future research is needed to define and validate threshold scores for existing diagnostic criteria for NMS. REFERENCES Gurrera RJ, Caroff SN, Cohen A, et al. An international consensus study of neuroleptic malignant syndrome diagnostic criteria using the Delphi method. J Clin Psychiatry. 2011;72: 1222–1228. Shalev A, Hermesh H, Munitz H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry. 1989;50:18–25. Modi S, Dharaiya D, Schultz L, Varelas P. Neuroleptic malignant syndrome: complications, outcomes, and mortality. Neurocrit Care. 2016;24:97–103. Pope HG, Keck PE, McElroy SL. Frequency and presentation of neuroleptic malignant syndrome in a large psychiatric hospital. Am J Psychiatry. 1986;143:1227–1233. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing Inc.;2013:709–711. Levenson JL. Neuroleptic malignant syndrome. Am J Psychiatry. 1985;142:1137–114...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Neurodegenerative Disease Neurology Original Research antipsychotics clozapine creatine kinase diagnosis drug overdose neuroleptic malignant syndrome quetiapine Source Type: research