Johnson V, Bruxner G
Prince Charles Hospital, Chermside, Queensland, Australia.
Aust N Z J Psychiatry. 1998 Dec;32(6):884-6. doi: 10.3109/00048679809073880.
The aim of the present paper is to report a case of Neuroleptic Malignant Syndrome (NMS) occurring 2 days after olanzapine was added to the treatment regimen of an elderly patient with Schizoaffective Disorder. The patient had a previous history of NMS associated with risperidone.
Two days after commencement of olanzapine, the patient presented in a stuporous state with dysarthria and increased muscle tone with cogwheeling. His level of consciousness fluctuated over the following 24 h with worsening rigidity, the onset of a mild fever, tachycardia and elevated blood pressure. Biochemical screening revealed markedly elevated creatine kinase.
Olanzapine was ceased and intravenous fluid replacement commenced. Hourly physical observations were instigated, as was regular serum monitoring of creatine kinase level.
Over the subsequent 48 h, there was gradual clinical improvement with resolution of dysarthria, ataxia, rigidity and fever. The patient was returned to the psychiatric ward 3 days after his admission to the medical ward.
Olanzapine therapy can be associated with NMS. To our knowledge, there are no previous reports of this in the literature.
本文旨在报告一例在一名患有分裂情感性障碍的老年患者治疗方案中加用奥氮平2天后发生的抗精神病药恶性综合征（NMS）。该患者既往有与利培酮相关的NMS病史。
奥氮平开始使用2天后，患者呈木僵状态，有构音障碍，肌张力增加伴齿轮样强直。在接下来的24小时内，其意识水平波动，强直加重，出现低热、心动过速和血压升高。生化检查显示肌酸激酶显著升高。
停用奥氮平并开始静脉补液。每小时进行一次体格检查，并定期监测血清肌酸激酶水平。
在随后的48小时内，临床症状逐渐改善，构音障碍、共济失调、强直和发热症状消退。患者入住内科病房3天后转回精神科病房。
奥氮平治疗可能与NMS相关。据我们所知，此前文献中尚无此类报道。
