Neuroleptic Malignant syndrome (NMS): a rare presentation induced by an antiemetic - case report

Area of Science:

• Pharmacology
• Neuroscience
• Psychiatry

Background:

• Neuroleptic Malignant Syndrome (NMS) is a rare but severe adverse reaction to antipsychotic medications.
• Antipsychotic therapy is crucial for managing conditions like paranoid schizophrenia.
• Hyper-salivation is a common side effect of antipsychotics, sometimes requiring treatment.

Observation:

• A 39-year-old male with a history of paranoid schizophrenia, stable on antipsychotics, was prescribed Hyoscine Hydrobromide for hyper-salivation.
• The patient had been on antipsychotic therapy for 21 years.
• No other medication changes were made concurrently.

Findings:

• Within 5 days of initiating Hyoscine Hydrobromide (Kwells), the patient developed symptoms consistent with Neuroleptic Malignant Syndrome.
• This suggests a potential drug interaction between Hyoscine Hydrobromide and antipsychotic medications.

Implications:

• Clinicians must exercise caution when prescribing anticholinergic medications like Hyoscine Hydrobromide to patients on antipsychotics.
• Awareness of this potential interaction is crucial for preventing severe adverse events such as NMS.
• Further investigation into the mechanisms of this interaction may be warranted.