Department of Psychiatry and Behavioral Science, School of Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA.
Neuropsychiatr Dis Treat. 2006 Jun;2(2):235-40. doi: 10.2147/nedt.2006.2.2.235.
The authors report three cases of neuroleptic malignant syndrome (NMS) induced by atypical antipsychotics (olanzapine and clozapine) which showed classic features of NMS including muscular rigidity and prominent fever.
Case reports.
A 66-year-old man with dementia and alcohol abuse developed NMS while on olanzapine for agitation and combativeness. A 62-year-old man with schizophrenia developed NMS 6 days after starting clozapine. A 43-year-old man with bipolar disorder developed NMS 14 days after starting clozapine. All three cases showed classic features of NMS including muscular rigidity and fever. Resolution of fever and muscular rigidity occurred within 72 hours with discontinuation of neuroleptics, supportive care, and lorazepam. The NMS rating scale reflected daily clinical improvement.
Classic NMS characterized by muscular rigidity and prominent fever may occur with atypical neuroleptics. Our cases suggest recovery from NMS associated with atypical neuroleptics may be hastened by lorazepam, as was previously reported for NMS from typical neuroleptics. Also, the NMS rating scale was sensitive to clinical improvement.
作者报告了三例由非典型抗精神病药物（奥氮平和氯氮平）引起的神经阻滞剂恶性综合征（NMS），这些病例均表现出 NMS 的典型特征，包括肌肉僵硬和明显发热。
病例报告。
一名 66 岁患有痴呆和酒精滥用的男性，因激越和攻击行为而服用奥氮平后发生 NMS。一名 62 岁患有精神分裂症的男性在开始服用氯氮平 6 天后发生 NMS。一名 43 岁患有双相情感障碍的男性在开始服用氯氮平 14 天后发生 NMS。所有三例均表现出 NMS 的典型特征，包括肌肉僵硬和发热。停用神经阻滞剂、支持性护理和劳拉西泮后，发热和肌肉僵硬在 72 小时内得到缓解。NMS 严重程度评分反映了每日的临床改善。
经典的 NMS 以肌肉僵硬和明显发热为特征，可能发生在使用非典型神经阻滞剂时。我们的病例表明，与典型神经阻滞剂引起的 NMS 一样，劳拉西泮可能加速与非典型神经阻滞剂相关的 NMS 的恢复。此外，NMS 严重程度评分对临床改善敏感。
