Chandad Miriam, Chlihfane Rajae, Kodad Safae, Oneib Bouchra, Elghazouani Fatima
Department of Psychiatry, Faculty of Medicine and Pharmacy, Mother and Child Health and Mental Health Research Laboratory, Mohammed I University, Oujda, Morocco.
Case Rep Psychiatry. 2024 May 10;2024:9936663. doi: 10.1155/2024/9936663. eCollection 2024.
The incidence of neuroleptic malignant syndrome justifies the immediate discontinuation of the drug in question and the reinstitution of therapy with another drug. In the case of resistant schizophrenia treated with clozapine, there are insufficient therapeutic options. We report the case of a young patient followed up for resistant schizophrenia who developed neuroleptic malignant syndrome after 5 years of therapy with clozapine. Clozapine therapy was successfully reinitiated, and the dosage was increased to 300 mg/day over 62 days. In light of this clinical case and a review of the literature, we report the possibility of reintroducing clozapine following an incidence of malignant syndrome in patients with resistant schizophrenia with respect to certain rules; in particular, a slow increase in dose after a reasonable period of time and close monitoring.
抗精神病药物恶性综合征的发生率表明应立即停用相关药物，并换用其他药物重新进行治疗。对于使用氯氮平治疗的难治性精神分裂症患者，治疗选择并不充分。我们报告了一例年轻的难治性精神分裂症患者，在接受氯氮平治疗5年后发生了抗精神病药物恶性综合征。氯氮平治疗得以成功重新开始，并在62天内将剂量增加至300毫克/天。鉴于此临床病例及文献回顾，我们报告了在难治性精神分裂症患者发生恶性综合征后，根据某些规则重新引入氯氮平的可能性；特别是在合理的时间段后缓慢增加剂量并密切监测。
