[Antipsychotic induced rhabdomyolysis]

Area of Science:

• Pharmacology
• Toxicology
• Clinical Medicine

Background:

• Post-traumatic stress disorder (PTSD) management often involves pharmacotherapy.
• Mirtazapine is an antidepressant sometimes used off-label or as an adjunct in PTSD treatment.
• Monitoring for adverse drug reactions is crucial during pharmacological treatment.

Observation:

• A 40-year-old patient with PTSD developed rhabdomyolysis shortly after initiating mirtazapine (30 mg/day).
• Creatine kinase (CK) levels rapidly increased to over 20,000 IU/L by day 3 of treatment.
• The clinical presentation and laboratory findings strongly suggested drug-induced rhabdomyolysis.

Findings:

• A diagnosis of mirtazapine-induced rhabdomyolysis was established.
• Discontinuation of mirtazapine coupled with supportive care, including hydration, resulted in complete patient recovery.
• No long-term nephrological complications were observed.

Implications:

• This case highlights the importance of recognizing mirtazapine as a potential cause of rhabdomyolysis.
• It underscores the critical role of medical biologists in diagnosing elevated creatine kinase activity and guiding appropriate laboratory test utilization.
• Understanding the physiopathology of drug-induced rhabdomyolysis is essential for effective patient management and prevention of complications.