Patil Vaibhav, Gupta Rishab, Verma Rohit, Balhara Yatan Pal Singh
Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
Oman Med J. 2016 Jul;31(4):309-11. doi: 10.5001/omj.2016.59.
Neuroleptic Malignant Syndrome (NMS) is an idiosyncratic and potentially life-threatening reaction to neuroleptic drugs. Lithium is a first-line mood stabilizer used in the treatment and prophylaxis of bipolar disorder. There are several case reports of lithium-associated NMS, but only when it was given in combination with antipsychotics. Therefore, the possibility of NMS being secondary to the antipsychotics could not be ruled out in those cases. Here we present a case of lithium-induced NMS in a patient who was not being treated concomitantly with any other agent known to cause NMS. The patient, a 74-year-old female with a 30-year history of bipolar affective disorder, was admitted to the emergency room of the All India Institute of Medical Sciences, New Delhi, with history of high fever and generalized weakness for 10 days before the admission. NMS was established based the presence of three cardinal symptoms. She was started on intravenous fluids to correct her sodium levels slowly and requested to follow-up at the psychiatry clinic.
抗精神病药恶性综合征（NMS）是一种对抗精神病药物的特异质性且可能危及生命的反应。锂盐是用于治疗和预防双相情感障碍的一线心境稳定剂。有几例锂盐相关的NMS病例报告，但均为锂盐与抗精神病药物联合使用时出现的情况。因此，在这些病例中不能排除NMS继发于抗精神病药物的可能性。在此，我们报告一例锂盐诱发的NMS病例，该患者未同时接受任何其他已知可导致NMS的药物治疗。患者为一名74岁女性，有30年双相情感障碍病史，因入院前10天出现高热和全身无力的症状入住新德里全印度医学科学研究所急诊室。根据三项主要症状确诊为NMS。开始给她静脉输液以缓慢纠正其钠水平，并要求其到精神科门诊随访。
