Document Detail


Neuroleptic malignant syndrome variant in a patient receiving donepezil and olanzapine.
MedLine Citation:
PMID:  18212788     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A 78-year-old man with a 22-year history of schizoaffective disorder and a 5-year history of dementia presented to the emergency department with a 5-day history of fatigue, progressive weakness, confusion and lethargy, and a 1-day history of severe muscle stiffness. For the past 10 years the patient had been treated with olanzapine for an unspecified psychiatric illness, without adverse effects. One week before presentation the patient was started on donepezil to treat mild dementia. INVESTIGATIONS: Physical examination, serum and urine laboratory evaluation, lumbar puncture, brain CT scan, brain MRI, electroencephalogram, chest X-ray, and electrocardiogram. DIAGNOSIS: A variant of neuroleptic malignant syndrome secondary to drug interaction. MANAGEMENT: Discontinuation of donepezil and olanzapine, aggressive intravenous hydration, intravenous dantrolene, and bromocriptine via a nasogastric tube. The patient was also administered intravenous antibiotics for aspiration pneumonia, and carbidopa-levodopa for residual parkinsonian features.
Authors:
Tanya C Warwick; Venkata Moningi; Prasuna Jami; Kristy Lucas; Ogochukwu Molokwu; Shalini Moningi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-01-22
Journal Detail:
Title:  Nature clinical practice. Neurology     Volume:  4     ISSN:  1745-8358     ISO Abbreviation:  -     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-06     Completed Date:  2008-04-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  101261799     Medline TA:  Nat Clin Pract Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  170-4     Citation Subset:  IM    
Affiliation:
University of California San Francisco, Fresno, University Center Specialty Medical Center, 2828 Fresno Street, Fresno, CA 93721, USA. twarwick@fresno.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Benzodiazepines / therapeutic use*
Cholinesterase Inhibitors / therapeutic use*
Humans
Indans / therapeutic use*
Male
Neuroleptic Malignant Syndrome / drug therapy*
Piperidines / therapeutic use*
Serotonin Uptake Inhibitors / therapeutic use*
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors; 0/Indans; 0/Piperidines; 0/Serotonin Uptake Inhibitors; 120011-70-3/donepezil; 12794-10-4/Benzodiazepines; 132539-06-1/olanzapine

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


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