title: Neuroleptic malignant syndrome-like reaction precipitated by antipsychotics in a patient with gamma-butyrolactone withdrawal.
abstract: We report the case of a patient with chronic abuse of gamma-butyrolactone (GBL, 3 bottles per week for 4 months), who in the course of the management of acute agitation and hallucinations developed symptoms compatible with both neuroleptic malignant syndrome and GBL withdrawal symptoms.Some GHB withdrawal symptoms are similar to those of neuroleptic malignant syndrome, and the administration of antipsychotics might worsen the neurological condition of patients. So, it seems important to rapidly detect drugs taken by patients with mental agitation, to optimize management and minimize complications related to drugs.
authors.affiliation: Department of Medical Pharmacology and Toxicology, Lapeyronie Hospital, Montpellier, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Eiden
authors.forename: Delphine
authors.initials: D
authors.lastname: Capdevielle
authors.forename: Charlotte
authors.initials: C
authors.lastname: Deddouche
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Boulenger
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Blayac
authors.forename: Hélène
authors.initials: H
authors.lastname: Peyrière
mesh_terms: D015107:4-Butyrolactone / Q000633:toxicity*; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002998:Clonazepam / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D005260:Female; D006212:Hallucinations / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D008152:Loxapine / Q000008:administration & dosage / Q000009:adverse effects; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis*; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000209:etiology*; D012997:Solvents / Q000633:toxicity*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology*; D019966:Substance-Related Disorders / Q000534:rehabilitation*
chemical_list: D014150:Antipsychotic Agents; D012997:Solvents; D002998:Clonazepam; D008152:Loxapine; D015107:4-Butyrolactone