Related Experiment Video

Updated: Aug 3, 2026

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
05:52

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis

Published on: November 21, 2013

Atypical neuroleptic malignant syndrome caused by olanzapine

J Nielsen1, A M Bruhn

  • 1Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg, Denmark. jimmin@ofir.dk

Acta Psychiatrica Scandinavica
|August 13, 2005
PubMed
Abstract

Insights

Neuroleptic malignant syndrome (NMS) can present atypically. This case highlights NMS in a patient treated with olanzapine, showing fluctuating hyperthermia and autonomic instability with minimal rigidity.

Area of Science:

  • Neuroscience
  • Psychiatry

Background:

  • Neuroleptic malignant syndrome (NMS) is a rare, life-threatening condition.
  • Classic NMS symptoms include rigidity, hyperthermia, altered mental status, and autonomic instability.

Observation:

  • This report details a single case of a patient with pneumonia who developed delirium.
  • The patient was treated with olanzapine, an atypical antipsychotic.
  • During treatment, the patient exhibited an atypical NMS presentation.

Findings:

  • The patient presented with fluctuating hyperthermia and autonomic instability over a month.
  • Significant rigidity was absent, and creatine kinase levels were not elevated.
  • Severe agitation and manic symptoms were observed.
  • Discontinuation of olanzapine led to the resolution of psychopathology and hyperthermia.

Implications:

  • This case underscores the importance of considering NMS in patients on antipsychotics, even with atypical presentations.
  • Clinicians should be vigilant for NMS symptoms beyond the classic rigidity, especially in patients treated with olanzapine.
  • Early recognition and drug discontinuation are crucial for managing NMS effectively.

More Related Videos

Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model06:08

Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model

Published on: February 10, 2023

Technique for Intranasal Administration of α-Synuclein Aggregates04:49

Technique for Intranasal Administration of α-Synuclein Aggregates

Published on: November 8, 2024

Related Concept Videos

Psychosis and Antipsychotic Drugs: Overview01:28

Psychosis and Antipsychotic Drugs: Overview

The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...
Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
Antipsychotic Drugs: Typical and Atypical Agents01:21

Antipsychotic Drugs: Typical and Atypical Agents

Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
Antipsychotic Drugs: Therapeutic Uses and Side Effects01:21

Antipsychotic Drugs: Therapeutic Uses and Side Effects

Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Mania and Antimanic Drugs: Overview01:24

Mania and Antimanic Drugs: Overview

Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as a...
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...