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Enzyme elevations in the neuroleptic malignant syndrome
1Psychiatry Service, Department of Veterans' Affairs Medical Center, Brockton, Massachusetts 02401.
Biological Psychiatry
|November 1, 1993
Summary
Serum enzyme elevations in neuroleptic malignant syndrome (NMS) likely originate from muscle tissue. This study found significant correlations between creatine phosphokinase (CPK) and other enzymes in NMS patients, suggesting a common muscle-related source.
Area of Science:
- Biochemistry
- Neurology
- Clinical Medicine
Background:
- Enzyme elevations are common in neuroleptic malignant syndrome (NMS).
- The significance and source of these elevated enzymes remain unclear.
- Creatine phosphokinase (CPK) is often elevated in NMS.
Purpose of the Study:
- To investigate the relationship between serum enzyme levels and CPK in patients with NMS.
- To determine the potential source of elevated enzymes in NMS.
- To differentiate enzyme elevations due to NMS from those caused by agitation.
Main Methods:
- Studied 37 patients with probable NMS and 83 psychiatric comparison patients.
- Measured serum levels of lactate dehydrogenase (LDH), glutamic oxaloacetic transaminase (GOT), aldolase, and alkaline phosphatase (AP).
- Compared enzyme levels to serum CPK levels within each patient group.
Main Results:
- All enzymes except AP significantly correlated with CPK in both groups.
- Enzyme-CPK correlations were substantially higher in the NMS group.
- Regression analyses indicated significant differences in CPK-LDH and CPK-GOT relationships between NMS and comparison groups.
Conclusions:
- Elevated serum enzymes in NMS likely stem from a common process originating in muscle tissue.
- These findings suggest muscle damage or increased enzyme release from myocytes in NMS.
- The observed enzyme elevations are not solely attributable to agitation or psychological stress.