Neuroleptic malignant syndrome in an adolescent after brief exposure to olanzapine.
A 17-year-old African-American male developed neuroleptic malignant syndrome (NMS) with hyperthermia, autonomic instability, increased muscle tone, rhabdomyolysis, and obtundation after a maximum of 2 days of treatment with olanzapine and 1 day of treatment with divalproex sodium. Intensive care unit (ICU)-level care was required. Paranoid psychosis with catatonia was present after recovery from the NMS. Because of his continued psychotic symptoms following resolution of the NMS, the alternate atypical antipsychotic, clozapine, was started under close observation. Reports of NMS resulting from atypical antipsychotic agents are generally uncommon, and much more so in the child and adolescent population. However, these agents are frequently prescribed in this population and require due caution.
Hanft
Alan
A
Department of Psychiatry and Human Behavior, University of California-Irvine, Orange, CA 92868, USA. ahanft@uci.edu
Eggleston
Christopher F
CF
Bourgeois
James A
JA
D000293:Adolescent; D001569:Benzodiazepines / Q000009:adverse effects*; D003024:Clozapine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D000077152:Olanzapine
D001569:Benzodiazepines; D003024:Clozapine; D000077152:Olanzapine