Risperidone-induced neuroleptic malignant syndrome : a case report

Area of Science:

• Psychiatry
• Neurology
• Pharmacology

Background:

• Neuroleptic Malignant Syndrome (NMS) is a rare but life-threatening condition associated with antipsychotic medications.
• Schizophrenia treatment often involves antipsychotics, necessitating awareness of potential adverse drug reactions like NMS.

Purpose of the Study:

• To report a case of NMS precipitated by risperidone in a young male schizophrenic patient.
• To evaluate the efficacy of specific treatments, bromocriptine and dantrolene, in managing NMS symptoms.
• To discuss the differential response of NMS symptom clusters to therapeutic interventions.

Main Methods:

• Clinical case presentation of a young male diagnosed with schizophrenia.
• Observation of NMS development following initiation of risperidone therapy.
• Administration of bromocriptine and subsequently dantrolene to manage NMS symptoms, with monitoring of clinical signs and creatine phosphokinase (CPK) levels.

Main Results:

• The patient presented with classic NMS symptoms, with risperidone identified as the likely causative agent.
• Rigidity and elevated CPK levels showed minimal improvement with bromocriptine.
• Dantrolene administration resulted in significant improvement of rigidity and normalization of CPK levels.

Conclusions:

• Dantrolene appears to be an effective treatment for NMS, particularly for rigidity and hyperthermia, in patients with schizophrenia.
• The differential response to bromocriptine and dantrolene suggests distinct pathophysiological mechanisms within NMS symptom clusters.
• This case underscores the importance of prompt recognition and targeted treatment of NMS in psychiatric patients receiving antipsychotic medication.