title: Antipsychotics leading to neuroleptic malignant syndrome in pregnancy.
abstract: BACKGROUND
  Neuroleptic malignant syndrome (NMS) is characterized by a tetrad of mental status changes, extrapyramidal symptoms, hyperpyrexia, and autonomic instability and can develop after the use of antipsychotics.
  
  
  METHODS
  A young, multiparous woman presented at 26 weeks of gestation with acute psychosis and was treated with haloperidol until she developed rigidity of her extremities and then was switched to risperidone. She subsequently developed mental status changes, rigidity, hyperthermia, and autonomic instability, leading to a diagnosis of NMS. Risperidone was discontinued and, owing to ongoing psychosis, olanzapine was initiated. Subsequently, her symptoms resolved.
  
  
  CONCLUSIONS
  Neuroleptic malignant syndrome may complicate the treatment of pregnant women using antipsychotics. Clinicians should take into account the risks of untreated psychosis when discontinuing the offending agent and consider initiating alternative pharmacotherapy.
authors.affiliation: From the Keck School of Medicine at the University of Southern California, Los Angeles, California.
authors.forename: Neda
authors.initials: N
authors.lastname: Ghaffari
authors.forename: Emily
authors.initials: E
authors.lastname: Dossett
authors.forename: Richard H
authors.initials: RH
authors.lastname: Lee
authors.forename: Paola
authors.initials: P
authors.lastname: Aghajanian
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D005260:Female; D006220:Haloperidol / Q000009:adverse effects*; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011618:Psychotic Disorders / Q000188:drug therapy; D018967:Risperidone / Q000009:adverse effects*
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone