Neuroleptic malignant syndrome secondary to aripiprazole initiation in a clozapine-intolerant patient

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Mitesh K Patel, Luigi Brunetti

Abstract

A case of neuroleptic malignant syndrome (NMS) secondary to aripiprazole in a schizophrenic patient previously managed with clozapine is reported. A 42-year-old Caucasian woman with a history of schizophrenia (chronic paranoid type) arrived at the emergency department (ED) with a chief complaint of altered mental status and oliguria. The patient was previously managed with clozapine for 14 years, which was well tolerated until the patient developed urinary retention. As a result, clozapine was gradually discontinued over several weeks. Aripiprazole 30 mg orally once daily was initiated four days before her arrival at the ED. Approximately four days after starting aripiprazole therapy, the patient began experiencing tremors, confusion, and rigidity. Physical examination revealed poor inspiratory effort, diffuse abdominal tenderness, and decreased muscle strength. Initial blood work confirmed acute renal failure and leukocytosis. The patient developed both hypokalemia and hypomagnesemia; her urine myoglobin level was suggestive of rhabdomyolysis. In light of her fever, encephalopathy, autonomic instability, elevated creatine kinase levels, and muscle rigidity, a diagnosis of NMS was made. Supportive care in the form of cooling bl...Continue Reading

References

Jun 1, 1992·Digestive Diseases and Sciences·M J SpirtD B Sachar
Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Mar 1, 1994·The Journal of Nervous and Mental Disease·V R VelamoorR E Antelo
Jan 1, 1993·The Medical Clinics of North America·S N Caroff, S C Mann
Nov 1, 1993·Biological Psychiatry·R J Gurrera, J A Romero
Oct 1, 1995·Journal of Clinical Psychopharmacology·P SachdevD Kissane
Sep 15, 1998·Psychiatric Services : a Journal of the American Psychiatric Association·A L PeloneroA K Pandurangi
Nov 6, 1998·Journal of the Neurological Sciences·C KawanishiK Kosaka
Aug 30, 2001·The Psychiatric Quarterly·V L Susman
Apr 6, 2004·Neurologic Clinics·Minal J Bhanushali, Paul J Tuite
May 26, 2004·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Patricia I RosebushMichael F Mazurek
Oct 16, 2004·International Clinical Psychopharmacology·Nandini Chakraborty, Timothy Johnston
Nov 27, 2004·Journal of the American Academy of Child and Adolescent Psychiatry·Scott SpaldingKaram Radwan
Jan 29, 2005·The American Journal of Psychiatry·Harpreet S Duggal, Joseph Kithas
Jun 22, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·David M GardnerPaul Waraich
Jul 6, 2005·Psychiatry Research·Perminder S Sachdev
Sep 15, 2005·Movement Disorders : Official Journal of the Movement Disorder Society·Mattia GambarinMichele Tinazzi
Jan 18, 2006·Journal of Clinical Psychopharmacology·Seksan SrephichitJames A Bourgeois
May 9, 2006·Schizophrenia Research·Jeffrey R Strawn
May 25, 2006·Journal of the American Academy of Child and Adolescent Psychiatry·Seth HammermanStanley N Caroff
Jul 21, 2006·Journal of Clinical Psychopharmacology·Syed AliPankaj Patel
Sep 16, 2006·Journal of Clinical Psychopharmacology·Seung-Gul KangJae-Seok Park
Feb 3, 2007·Clinical Neuropharmacology·Hima B PalakurthiStuart Kaplan
Apr 7, 2007·Journal of Clinical Psychopharmacology·Julie BrunelleFlorence Thibaut
Apr 7, 2007·Journal of Psychiatric Practice·Harun EvcimenJack M Gorman
Jul 4, 2007·Primary Care Companion to the Journal of Clinical Psychiatry·Daniel MolinaXiaohui Lu
Dec 12, 2007·The Journal of Neuropsychiatry and Clinical Neurosciences·Harpreet S Duggal
Nov 5, 2008·The American Journal of Psychiatry·Phillip B MarshallShana Xuanlan C Nguyen
Dec 5, 2008·Bioconjugate Chemistry·Raghavendra S NavathRangaramanujam M Kannan

❮ Previous
Next ❯

Citations

Jun 21, 2013·Clinical Neuropharmacology·Masamichi IshiokaNorio Sugawara
Apr 5, 2014·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Deepak Hanumanthaiah, Kumar Ramanathan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Related Papers

Progress in Neuro-psychopharmacology & Biological Psychiatry
D DassaJ C Samuelian
Movement Disorders : Official Journal of the Movement Disorder Society
Maximilian GahrBirgit Abler
Progress in Neuro-psychopharmacology & Biological Psychiatry
Matej KastelicVita Dolzan
© 2021 Meta ULC. All rights reserved