Clozapine-induced neuroleptic malignant syndrome. 1991

K DasGupta, and A Young
Department of Psychiatry, University of Wisconsin, Madison.

Neuroleptic malignant syndrome (NMS), a rare but serious side effect of psychotropic drugs, is usually attributed to blockade of striatal and hypothalamic dopaminergic tracts. Clozapine is an atypical antipsychotic that has minimal extrapyramidal effects and might not be expected to cause NMS. The authors report the development of NMS in a 30-year-old white man after three 25-mg clozapine doses. To their knowledge, this is the first case of NMS linked with clozapine in which concurrent psychotropic medications cannot be implicated.

UI MeSH Term Description Entries
D008297 Male Males
D009459 Neuroleptic Malignant Syndrome A potentially fatal syndrome associated primarily with the use of neuroleptic agents (see ANTIPSYCHOTIC AGENTS) which are in turn associated with dopaminergic receptor blockade (see RECEPTORS, DOPAMINE) in the BASAL GANGLIA and HYPOTHALAMUS, and sympathetic dysregulation. Clinical features include diffuse MUSCLE RIGIDITY; TREMOR; high FEVER; diaphoresis; labile blood pressure; cognitive dysfunction; and autonomic disturbances. Serum CPK level elevation and a leukocytosis may also be present. (From Adams et al., Principles of Neurology, 6th ed, p1199; Psychiatr Serv 1998 Sep;49(9):1163-72) Neuroleptic-Induced Neuroleptic Malignant Syndrome,Neuroleptic-Malignant Syndrome, Neuroleptic Induced,NMS (Neuroleptic Malignant Syndrome),NMSs (Neuroleptic Malignant Syndrome),Neuroleptic Induced Neuroleptic Malignant Syndrome,Neuroleptic Malignant Syndrome, Neuroleptic Induced,Neuroleptic Malignant Syndromes,Syndrome, Neuroleptic Malignant,Syndromes, Neuroleptic Malignant
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D002389 Catatonia A neuropsychiatric disorder characterized by one or more of the following essential features: immobility, mutism, negativism (active or passive refusal to follow commands), mannerisms, stereotypies, posturing, grimacing, excitement, echolalia, echopraxia, muscular rigidity, and stupor; sometimes punctuated by sudden violent outbursts, panic, or hallucinations. This condition may be associated with psychiatric illnesses (e.g., SCHIZOPHRENIA; MOOD DISORDERS) or organic disorders (NEUROLEPTIC MALIGNANT SYNDROME; ENCEPHALITIS, etc.). (From DSM-IV, 4th ed, 1994; APA, Thesaurus of Psychological Index Terms, 1994) Catatonia, Malignant,Catatonia, Organic,Lethal Catatonia,Organic Catatonic Disorder,Schizophreniform Catatonia,Catatonia, Lethal,Catatonia, Schizophreniform,Catatonias,Catatonias, Lethal,Catatonias, Malignant,Catatonias, Organic,Catatonias, Schizophreniform,Catatonic Disorder, Organic,Catatonic Disorders, Organic,Lethal Catatonias,Malignant Catatonia,Malignant Catatonias,Organic Catatonia,Organic Catatonias,Organic Catatonic Disorders,Schizophreniform Catatonias
D003024 Clozapine A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. Clozaril,Leponex
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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