Document Detail


Neuroleptic-induced catatonia: clinical presentation, response to benzodiazepines, and relationship to neuroleptic malignant syndrome.
MedLine Citation:
PMID:  20075641     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neuroleptic-induced catatonia (NIC), manifested in an extrapyramidal-catatonic syndrome, has been sporadically reported in the literature. Confusion surrounds its relationship to neuroleptic malignant syndrome (NMS) and extrapyramidal reactions to neuroleptics. This study examined (a) its clinical presentation and response to benzodiazepines, (b) the hypothesis that NIC and NMS are on the same spectrum with a continuum of symptom progression, and (c) its possible relationship to extrapyramidal reactions. Of 127 episodes of acute catatonia prospectively identified, 18 were diagnosed with NIC. All catatonia episodes received benzodiazepines. The NIC episodes were analyzed noting their clinical presentations, laboratory findings, and responses to treatments. Their responses to benzodiazepines were compared, with retrospective rating on a 7-point scale, to that for catatonia episodes associated with mania and schizophrenia. The progression of symptoms in each NIC episode was reviewed. The NIC episodes presented predominantly in the stuporous form associated with parkinsonism. Delirium, autonomic abnormality, and elevated serum creatine phosphokinase were all common. Neuroleptic malignant syndrome was diagnosed in 3 episodes (17%). The 3 catatonia groups did not differ significantly in their benzodiazepines responses: 78% (14/18) of NIC, 75% (12/16) of manic catatonia, and 67% (34/51) of schizophrenic catatonia episodes showed full responses. A spectrum of presentation across episodes was noted with simple NIC without delirium, autonomic disturbances, or fever at one end and NMS or malignant NIC at the other end. Symptoms in individual episodes showed a similar continuum progression. No extrapyramidal reactions immediately preceded the NIC episodes. Findings of this study support the hypothesis that NIC and NMS are disorders on the same spectrum and reveal no indication that extrapyramidal reactions progress to NIC.
Authors:
Joseph W Y Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  30     ISSN:  1533-712X     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-15     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-10     Citation Subset:  IM    
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Graylands Hospital, Mount Claremont, Perth, Australia. Joseph.Lee@health.wa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antipsychotic Agents / adverse effects*
Benzodiazepines / therapeutic use*
Catatonia / chemically induced*,  diagnosis,  drug therapy*
Diagnosis, Differential
Disease Progression
Female
Humans
Male
Middle Aged
Neuroleptic Malignant Syndrome / diagnosis*,  drug therapy,  etiology
Prospective Studies
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 12794-10-4/Benzodiazepines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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