title: Rechallenging clozapine after neuroleptic malignant syndrome.
abstract: Neuroleptic malignant syndrome (NMS) is a potentially fatal manifestation of antipsychotic use associated with symptoms that include mental status changes, muscle rigidity, fever and autonomic dysfunction. An occurrence of NMS with clozapine has been reported in the past but there are very few reports of successfully rechallenging the drug in individuals who have developed the syndrome. This case report discusses one of the few instances in literature where clozapine has been re-administered successfully to a patient without a reoccurrence of NMS. In conclusion, a rechallenge of clozapine after neuroleptic malignant syndrome can be done if care is taken to avoid concurrent use of lithium and other psychotropics, monitoring for NMS symptoms and titrating the dose upward slowly after a reasonable period of time.
authors.affiliation: University of Missouri, One Hospital Drive, Columbia, MO, 65212, USA, anbalagane@health.missouri.edu.
authors.forename: Emaya
authors.initials: E
authors.lastname: Anbalagan
authors.forename: Muaid
authors.initials: M
authors.lastname: Ithman
authors.forename: John
authors.initials: J
authors.lastname: Lauriello
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D003024:Clozapine / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D011618:Psychotic Disorders / Q000188:drug therapy; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine