"Brief" Aripiprazole-induced Neuroleptic Malignant Syndrome with Symptoms that Only Lasted a Few Hours

Area of Science:

• Pharmacology
• Neurology
• Toxicology

Background:

• Neuroleptic malignant syndrome (NMS) is a rare but life-threatening adverse reaction to antipsychotic medications.
• Atypical NMS, often associated with newer antipsychotics like aripiprazole, may present with less pronounced symptoms.
• Post-surgical patients may be at increased risk for adverse drug reactions.

Observation:

• A 64-year-old male patient developed NMS following aripiprazole treatment post-surgery.
• The patient exhibited brief, characteristic NMS symptoms including fever, rigidity, and altered mental status.
• Early NMS diagnosis was aided by elevated creatine kinase and low serum iron levels.

Findings:

• Aripiprazole-induced NMS can manifest with rapidly resolving, yet significant, clinical signs.
• Biochemical markers such as creatine kinase and serum iron levels can be key indicators for NMS diagnosis.
• Discontinuation of the offending agent and supportive care led to the patient's recovery.

Implications:

• Clinicians must maintain a high index of suspicion for NMS, even with atypical presentations or brief symptom duration.
• Awareness of aripiprazole's potential to cause NMS is critical for patient safety.
• Prompt recognition and management of NMS are essential to prevent severe morbidity and mortality.