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Psychiatria Danubina, Vol. 30 No. suppl. 7, 2018.

Conference paper

NEUROLEPTIC MALIGNANT SYNDROME IN A PATIENT TREATED WITH CLOTIAPINE

Clémentine Lantin ; Mental Health Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
Miriam Franco ; Mental Health Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
François-Xavier Dekeuleneer ; Mental Health Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
Didier Chamart ; Mental Health Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium
Juan Martin Tecco ; Mental Health Unit, Centre Hospitalier Universitaire et Psychiatrique de Mons-Borinage (CHUP-MB), Mons, Belgium

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Abstract

Background: Neuroleptic malignant syndrome (NMS), which is linked to the use of antipsychotic medication, is a potentially
lethal neurological emergency. The interest of our study is that NMS induced by the use of clotiapine has never previously been
described.
Subjects and methods: We present the case of a 61-year old man whose sleep disorders were treated with clotiapine 40 mg/day. After 7 days of taking 40 mg clotiapine, the patient presented with a deterioration of his general health which had gradually taken hold, with altered consciousness accompanied by generalised muscle rigidity and hypersalivation. Laboratory blood tests revealed elevated levels of Creatine Phosphokinase (CPK) at 812 U/l. The patient was diagnosed with NMS and treated accordingly.
Results: The mechanism that underlies the appearance of NMS remains largely unknown. Clotiapine is a second-generation
antipsychotic, first released onto the market in the 1970s, and is available in a few countries, including Belgium. NMS is treated as a medical emergency due to the possibility of morbidity and death. The first step in the treatment of NMS consists in withholding the agent suspected of provoking the symptoms.
Conclusions: NMS is difficult to diagnose due to a great variability in clinical presentations and the absence of specific tests and
laboratory results. The use of clotiapine in treating sleep disorders can provoke NMS as a life-threatening side-effect. To our
knowledge, this is the first time a case of clotiapine-induced NMS has been published.

Keywords

neuroleptic malignant syndrome; clotiapine; sleep disorder

Hrčak ID:

262956

URI

https://hrcak.srce.hr/262956

Publication date:

21.11.2018.

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