[Paroxetine-induced neuroleptic malignant syndrome].
We report on a 22-year-old schizophrenic patient who attempted suicide and suffered an epidural hemorrhage. 16 days after the neurosurgical operation. After several weeks of treatment with promethazine, 1 day after intake of paroxetin he partially lost consciousness and developed extrapyramidal symptoms and vegetative disorders. Hyper-Ck-aemia up to 680 U/l was observed. Malignant neuroleptic syndrome (MNS) was diagnosed, which led to withdrawal of paroxetin and promethazine. He was put on dantamacrine and amantadine until the symptoms resolved. To date there have been few reports on MNS under tricyclic antidepressants and selective serotonin inhibitors. The influence of the central serotonergic system on the pathophysiology of MNS is discussed.
Heinemann
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F
Neurologische Abteilung, St.-Josef-Krankenhaus, Moers.
Assion
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HJ
Hermes
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Ehrlich
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D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D004359:Drug Therapy, Combination; D006408:Hematoma, Subdural / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D009460:Neurologic Examination / Q000187:drug effects; D017374:Paroxetine / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000139:chemically induced / Q000188:drug therapy / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy* / Q000235:genetics; D012565:Schizophrenic Psychology; D013406:Suicide, Attempted / Q000523:psychology*
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D017374:Paroxetine