Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

Neuroleptic malignant syndrome with clomipramine

Document Type : Case report

Authors
Saber Dooqaei Moghadam 1
Sepide Hejazi 2
ALI Moradi 3
Anahita Barqi 1
Sahar Ravanshad 1
1 Department of internal medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/mjms.2023.68776.4086
Abstract
Neuroleptic malignant syndrome (NMS) is a neurologic emergency condition that may arise as a result of the administration of potent psychotropic agents but it is not only antipsychotics alone that should be blamed for being behind the occurrence of this syndrome . This syndrome is characterized by fever and rigidity. Further symptoms include impaired consciousness, autonomic dysfunction, increased creatine kinase (CK), and leukocytosis. We report a case of a middle age woman with a past medical history of depression presented to the emergency room with alteration of mental status , neuromuscular hyper excitability, pyrexia, muscle rigidity and urinary incontinence following ingestion of clomipramine, a drug not noted for dopamine blockade. A firm diagnosis of NMS was made . After discontinue medication, therapy with Bromocriptine and Lorazepam was started. Within a few days, the patient improved significantly and CPK level returned to normal after 5 days.It is necessary to mention that the use of drugs other than antipsychotic agents can lead to NMS. Likely, the number of agents that can precipitate this syndrom will most probably increase by years.
Keywords
Neuroleptic malignant syndrome
antipsychotics
creatine kinase
clomipramine
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Medical Journal of Mashhad university of Medical Sciences
Volume 67, Issue 1
March and April 2024
Pages 67-71