Citation

Zaluska M, Brykalski J, Kszczotek M, Janota B, Dyduch A. Postep. Psychiatr. Neurol. 2014; 23(4): 202-205.

Copyright

(Copyright © 2014, Instytut Psychiatrii I Neurologii)

DOI

10.1016/j.pin.2014.10.001

PMID

unavailable

Abstract

Neuroleptic malignant syndrome (NMS) is a rare and potentially lethal complication of antipsychotic medication. We have found in the literature six case reports of NMS associated with amisulpride, however in three of them concomitant factors played a probable role. We present a case of NMS, which appeared 10 days after addition of amislupride to ongoing lithium and valproic acid therapy in a patient with bipolar disorder. The onset of NMS was preceded by symptoms of lithium toxicity. Total resolution of all NMS symptoms was achieved 23 days after discontinuation of lithium and amisulpride. Neverthe- less, 36 days later, after 20 days of medication with quetiapine added to valproic acid, there occurred elevation of serum creatine kinase (CK) and myoglobin levels with no prior clinical manifestation of NMS. The case indicates the increased risk of NMS due to amisulpride added to lithium. The susceptibility to NMS is present even after symptoms resolution. For that reason, the serum CK and myoglobin levels should be controlled if antipsychotic medication is implemented in patients with past history of NMS although clinical symptoms of NMS are absent. © 2014 Institute of Psychiatry and Neurology. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Language: en

Keywords

adult; disability; human; male; case report; bipolar disorder; insomnia; depression; psychosis; suicide attempt; disease predisposition; clinical feature; tachycardia; psychiatric department; quetiapine; middle aged; lithium carbonate; diazepam; confusion; olanzapine; diarrhea; tremor; drug withdrawal; irritability; delirium; fever; valproic acid; disorientation; mania; hypertension; hypomania; amisulpride; agitation; aspartate aminotransferase; creatine kinase; clonazepam; protein blood level; bromocriptine; hyponatremia; muscle rigidity; laboratory test; disease duration; calcium; add on therapy; neuroleptic malignant syndrome; stupor; calcium blood level; Article; hyperthermia; tachypnea; hypokalemia; drug dose increase; treatment duration; drug substitution; Neuroleptic malignant syndrome; creatine kinase blood level; sleep time; myoglobin; Amisulpride; lithium blood level; perseveration; Lithium carbonate; sensory system