Incipient neuroleptic malignant syndrome with quetiapine/paroxetine combination treatment: atypical presentation and early, successful rechallenge with olanzapine. 2005

Sylvain Grignon, and Jean Ianic Brethes, and Martine Chamberland, and Daniel B Guimaraes
Department of Psychiatry, Sherbrooke University, Quebec, Canada.

A 26-year-old caucasian male developed incipient neuroleptic malignant syndrome (NMS) during the course of paranoid schizophrenia with catatonic signs at admission, while on quetiapine/paroxetine combination treatment. The clinical presentation was "atypical", but increased creatine kinase levels and positive myoglobinemia were highly suggestive of the diagnosis. Of note, the patient was successfully rechallenged with olanzapine. The implications of the drug regimen and of the catatonic presentation are discussed.

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