Successful treatment of a complicated case of neuroleptic malignant syndrome.
Neuroleptic malignant syndrome (NMS) is a life-threatening reaction often related to neuroleptic drugs, characterized by rigidity, hyperthermia, altered consciousness, and fluctuating blood pressure. We present a case of NMS that followed a doubled oral dose of a drug compound: tranylcypromine sulfate, a monoamine oxidase inhibitor, and trifluoperazine (neuroleptic). The case was complicated by rhabdomyolisis and disseminated intravascular coagulation. It was treated successfully with dantrolene sodium and generous fluid therapy without using neuromuscular blocking agents or dopamine agonists.
Intensive Care Unit, M.G. Vannini Hospital, Via A. Bullicante no. 4, 00177 Rome, Italy. aldo.castagna@libero.it
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Lappa
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Podestà
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Capelli
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Castagna
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Di Placido
D
D
Alampi
F
F
Semeraro
D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D003620:Dantrolene / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007262:Infusions, Intravenous; D007558:Italy; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009459:Neuroleptic Malignant Syndrome / Q000150:complications / Q000188:drug therapy*; D012206:Rhabdomyolysis / Q000150:complications; D014191:Tranylcypromine / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014268:Trifluoperazine / Q000008:administration & dosage / Q000009:adverse effects
D014150:Antipsychotic Agents; D008996:Monoamine Oxidase Inhibitors; D009125:Muscle Relaxants, Central; D014268:Trifluoperazine; D014191:Tranylcypromine; D003620:Dantrolene