Neuroleptic malignant syndrome in an elderly patient with bipolar disorder

Woon, Luke Sy-Cherng and Nazirah A, and Mohd Muhaimin MH, and Hatta Sidi, and Wan Asyraf Wan Zaidi, (2021) Neuroleptic malignant syndrome in an elderly patient with bipolar disorder. Medicine & Health, 16 (2). pp. 274-279. ISSN 2289-5728

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Official URL: https://medicineandhealthukm.com/toc/16/2

Abstract

Neuroleptic malignant syndrome (NMS) is a well-known and potentially fatal complication of antipsychotic use. The elderly population, with multiple risk factors, are more vulnerable to this condition. We described a case of an 80-year-old man with bipolar disorder, previously on oral extended-release sodium valproate, aripiprazole and long-acting injectable paliperidone, who developed NMS. He presented with generalised muscle rigidity, fever, fluctuating blood pressure and elevated creatinine kinase during his hospitalisation for a manic episode. Contributing factors included old age, underlying vascular Parkinsonism, electrolyte imbalance, intercurrent lung infection with acute exacerbation of chronic obstructive pulmonary disease, hyperactive delirium, and repeated administration of parenteral typical antipsychotic. Antipsychotics were withheld promptly, and the patient was treated with dantrolene, bromocriptine and amantadine. His symptoms resolved after a week. He subsequently remained well with oral extended-release sodium valproate alone. Relevant clinical points are discussed. Clinical vigilance, close interdisciplinary cooperation, and prompt interventions are keys to successful to management of NMS in elderly patients.

Item Type:Article
Keywords:Antipsychotic; Delirium; Elderly; Haloperidol; Neuroleptic malignant syndrome; Vascular parkinsonism
Journal:Medicine & Health
ID Code:18284
Deposited By: ms aida -
Deposited On:24 Mar 2022 06:19
Last Modified:25 Mar 2022 01:57

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