[Increase in serum creatine phosphokinase following administration of talipexole hydrochloride]

We presented a 60-year-old man with a 12 year history of Parkinson's disease. The wearing-off phenomenon occurred 3 years after starting L-dopa. The patient was admitted to this unit in order to readjust his medication Administration of talipexole hydrochloride was initiated, the patient complained of an aggravation of Parkinsonism, and increases in serum creatine phosphokinase (CK) levels to 1,875 IU/l was observed. The dosage of talipexole was gradually reduced and the drug was ultimately discontinued since incomplete neuroleptic malignant syndrome was suspected. Serum CK levels then gradually decreased and returned to normal. Literature retrieval revealed two cases of neuroleptic malignant syndrome following administration of bromocriptine mesilate. Therefore, neuroleptic malignant syndrome should be considered when initiation of dopamine agonist worsens Parkinsonism.