[Neuroleptic malignant syndrome in a patient treated with olanzapine].
BACKGROUND
Neuroleptic malignant syndrome is a potentially fatal reaction to antipsychotic drugs, characterised by hyperthermia, rigidity, autonomic instability and muscle injury. The syndrome was originally associated with traditional neuroleptics, but may also occur during treatment with second-generation atypical antipsychotic drugs.


METHODS
We present a case of neuroleptic malignant syndrome in a 52-year-old patient who had been treated for 2(1/2) years with olanzapine, a new atypical antipsychotic agent. He had previously been treated with a conventional neuroleptic for 25 years.


RESULTS
For 2-3 days the patient's condition was serious and unstable, requiring care in the emergency unit. When he was discharged after 12 days' hospitalisation, he was still physically disabled and needed care in his home.


CONCLUSIONS
Neuroleptic malignant syndrome may develop even after long and stable treatment with atypical antipsychotic agents. The condition should be suspected in psychiatric patients who present with unclear hyperthermia and muscular rigidity. Essential therapeutic principles are cooling, rehydration, correction of electrolytic disturbances, cardiac monitoring, regular tests of renal function and creatine kinase. Treatment of malign hyperthermia with dantrolene should also be considered.
Medisinsk avdeling, Orkdal Sanitetsforenings Sjukehus, 7300 Orkanger.
Guro
G
Horni
Kathinka
K
Meirik
May Brit
MB
Lund
D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis / Q000209:etiology*; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D010890:Pirenzepine; D017367:Selective Serotonin Reuptake Inhibitors