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Neuroleptic syndrome

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https://www.readbyqxmd.com/read/30315014/demystifying-serotonin-syndrome-or-serotonin-toxicity
#1
REVIEW
Ai-Leng Foong, Kelly A Grindrod, Tejal Patel, Jamie Kellar
OBJECTIVE: To review the symptoms of serotonin toxicity (commonly referred to as serotonin syndrome ) and the causative drugs and their mechanisms of action, and to equip primary care providers with practical strategies to prevent and identify serotonin toxicity. QUALITY OF EVIDENCE: PubMed and Google Scholar were searched for relevant articles on serotonin toxicity, the causes, and the differential diagnosis using search terms related to serotonin toxicity ( serotonin syndrome, serotonin toxicity, serotonin overdose ), causes (individual names of drug classes, individual drug names), and diagnosis ( differential diagnosis, neuroleptic malignant syndrome, anticholinergic toxicity, discontinuation syndrome, malignant hyperthermia, serotonin symptoms )...
October 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/30254795/atypical-neuroleptic-malignant-syndrome-precipitated-by-clozapine-and-quetiapine-overdose-a-diagnostic-challenge
#2
David Choon Liang Teo, Hon Khuan Wong, Sheng Neng Tan
Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic, but life-threatening adverse reaction associated with the use of antipsychotic drugs. It is characterized by a tetrad of fever, rigidity, autonomic instability, and altered mental status. Failure to diagnose NMS early and institute appropriate treatment can result in serious medical complications and death. While diagnostic criteria for NMS exist, atypical presentations that lack one or more characteristic features pose a diagnostic dilemma to clinicians...
July 2018: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/30198916/postmortem-hyperthermia-two-case-reports-and-a-review-of-the-literature
#3
Franchi Angélique, Gauchotte Guillaume, Gambier Nicolas, Raul Jean Sébastien, Martrille Laurent
In this daily practice, the forensic pathologist is rarely confronted with postmortem hyperthermia associated with the rapid onset of rigor mortis. We report 2 similar cases where the rectal temperature value taken during the on-scene investigations by the forensic pathologist was greater than 40°C (104°F) in both cases, and rigor mortis was complete within less than 6 hours postmortem. The first case was due to a deadly intoxication by ecstasy and the second one to the deadly association of methadone and a possible neuroleptic malignant syndrome...
September 6, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/30187438/diagnosis-and-treatment-of-acute-alcohol-intoxication-and-alcohol-withdrawal-syndrome-position-paper-of-the-italian-society-on-alcohol
#4
Fabio Caputo, Roberta Agabio, Teo Vignoli, Valentino Patussi, Tiziana Fanucchi, Paolo Cimarosti, Cristina Meneguzzi, Giovanni Greco, Raffaella Rossin, Michele Parisi, Davide Mioni, Sarino Arico', Vincenzo Ostilio Palmieri, Valeria Zavan, Pierluigi Allosio, Patrizia Balbinot, Maria Francesca Amendola, Livia Macciò, Doda Renzetti, Emanuele Scafato, Gianni Testino
The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3-5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few physicians are adequately trained in identifying and treating AWS. The Italian Society on Alcohol has, therefore, implemented a task force of specialists to draw up recommendations for the treatment of AWS with the following main results: (1) while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated; (2) out-patient treatment is appropriate in patients with mild or moderate AWS, while patients with severe AWS need to be treated as in-patients; (3) benzodiazepines, BDZs are the "gold standard" for the treatment of AWS and DTs; (4) alpha-2-agonists, beta-blockers, and neuroleptics may be used in association when BDZs do not completely resolve specific persisting symptoms of AWS; (5) in the case of a refractory form of DTs, the use of anaesthetic drugs (propofol and phenobarbital) in an intensive care unit is appropriate; (6) alternatively to BDZs, sodium oxybate, clomethiazole, and tiapride approved in some European Countries for the treatment of AWS may be employed for the treatment of moderate AWS; (7) anti-convulsants are not sufficient to suppress AWS, and they may be used only in association with BDZs for the treatment of refractory forms of convulsions in the course of AWS...
September 5, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/30181086/what-a-neurologist-should-know-about-pet-and-spect-functional-imaging-for-parkinsonism-a-practical-perspective
#5
Stéphane Thobois, Stéphane Prange, Christian Scheiber, Emmanuel Broussolle
The diagnosis of a parkinsonian syndrome based on clinical criteria remains sometimes difficult, especially at disease onset. Brain or heart molecular imaging techniques (SPECT or PET) can provide a major help to improve and speed up diagnosis, influencing treatment strategies. Presynaptic dopaminergic imaging using either [18 F]-Dopa PET or 123 I -2β-Carbomethoxy-3β-(4-Iodophenyl)- N-(3-Fluoropropyl) Nortropane ([123 I]-Ioflupane)SPECT demonstrates or rules out the presence of a dopaminergic degenerative process...
August 30, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/30128733/-antipsychotic-induced-motor-symptoms-in-schizophrenic-psychoses-part-2-catatonic-symptoms-and-neuroleptic-malignant-syndrome
#6
REVIEW
D Hirjak, A Sartorius, K M Kubera, R C Wolf
In rare cases, pharmacotherapy in schizophrenic psychoses can be associated with life-threatening antipsychotic-induced movement disorders. The two most severe complications are antipsychotic-associated catatonic symptoms (ACS) and neuroleptic malignant syndrome (NMS). Although both constellations necessitate rapid medical care, the diagnosis is still a clinical challenge. Although there is no established treatment of ACS (here designated as a specific subtype of catatonic symptoms), an attempt should be made with benzodiazepines and memantine can also be helpful...
August 20, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/30112240/a-case-of-neuroleptic-malignant-syndrome-in-a-profoundly-intellectually-disabled-patient-with-successful-reintroduction-of-antipsychotic-therapy-with-quetiapine
#7
Kamal Patel, Brandon Lilly, Oluwadamilare Ajayi, Kelly Melvin
Neuroleptic Malignant Syndrome (NMS) is a rare condition clinically characterized by muscle rigidity, hyperthermia, autonomic instability, and acute mental status change. NMS is most often associated with use of high-potency first-generation antipsychotic medications; though, other neuroleptics have been implicated as well. NMS can be fatal with estimated mortality rates as high as 20%. Patients experiencing certain severe complications, including renal failure, have been associated with mortality as high as 50%, stressing the need for early recognition and treatment...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/30100569/levosulpiride-induced-neuroleptic-malignant-syndrome-in-rheumatoid-arthritis
#8
Devashish Desai, Kartik Gupta, Rohit Kumar, Ashutosh Biswas
A 53-year-old woman, known case of diabetes mellitus and rheumatoid arthritis, presented with a 4-day history of hyperthermia, rigidity, tremor and altered sensorium. She developed these symptoms after having been administered parenteral levosulpiride to control vomiting due to secondary adrenal insufficiency. We managed her as a case of life-threatening neuroleptic malignant syndrome (NMS) requiring mechanical ventilation, bromocriptine and other supportive care. She subsequently recovered and was discharged in a stable condition...
August 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/30087734/forced-diuresis-and-expedient-blood-pressure-control-in-the-management-of-quetiapine-induced-neuroleptic-malignant-syndrome-a-case-report
#9
Neville Aquilina, Vincent Bugeja
BACKGROUND: This case report intends to highlight the importance of safeguarding renal function from rhabdomyolysis in neuroleptic malignant syndrome (NMS) by concomitant administration of parenteral fluids at a high rate together with high doses of parenteral loop diuretics (we utilised 6 mg bumetanide daily) and tailed over a few days, in order to preserve glomerular/renal medullary perfusion and nephron function. CASE REPORT: This case describes an elderly lady previously diagnosed with Lewy body dementia who had been started on low dose quetiapine a few days previously and presented with an acute 24 - 48 hour onset of fever, generalised stiffness, rapidly becoming uncommunicable and with high blood pressure...
July 20, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/30076161/neuroleptic-malignant-syndrome-following-reintroduction-of-an-antipsychotic-after-overdose
#10
Théo Korchia, Graham Blackman, Michel Cermolacce, Raphaëlle Richieri
Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse drug reaction. We report a case of NMS potentially induced by dehydration in a female patient suffering from schizoaffective disorder. We discuss possible aetiologies and triggering factors alongside the existing literature.
August 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29992532/refining-the-psychiatric-syndrome-of-anti-n-methyl-d-aspartate-receptor-encephalitis
#11
REVIEW
N Warren, D Siskind, C O'Gorman
OBJECTIVE: To review the psychiatric symptoms of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, in an attempt to differentiate the presentation from a primary psychiatric disorder. METHOD: A systematic literature review of PubMed and EMBASE of all published cases of anti-NMDA receptor encephalitis was performed from inception to January 2018. RESULTS: There were 706 cases of anti-NMDA receptor encephalitis identified. Cases were typically young (mean age 22...
July 10, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29992074/diagnostic-treatment-and-system-challenges-in-the-management-of-recurrent-neuroleptic-malignant-syndrome-on-a-general-medical-service
#12
Karan Verma, Vivek Jayadeva, Raymond Serrano, Karthik Sivashanker
Neuroleptic malignant syndrome (NMS), an iatrogenic form of malignant catatonia, carries high morbidity and mortality rates especially in the context of delayed recognition and standard intervention protocol of lorazepam trial. However, there is limited guidance available through literature for further management if benzodiazepine treatment is ineffective and electroconvulsive therapy (ECT) is not readily accessible. This case report describes a multimodal approach to address the diagnostic, treatment, and logistical system challenges in an acute medical hospital through the case of a 69-year-old man with schizophrenia who represented from a psychiatric ward with neuroleptic malignant syndrome...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29954366/subjective-well-being-drug-attitude-and-changes-in-symptomatology-in-chronic-schizophrenia-patients-starting-treatment-with-new-generation-antipsychotic-medication
#13
Christian G Widschwendter, Georg Kemmler, Maria A Rettenbacher, Nursen Yalcin-Siedentopf, Alex Hofer
BACKGROUND: Non-adherence to medication remains a major challenge in the long-term management of patients with schizophrenia. Next to lack of insight into the illness, adverse effects of antipsychotic drugs, cognitive deficits, poor therapeutic alliance, reduced quality of life, missing social support, and negative attitudes toward medication are predictors of non-adherence. This study examined potential correlations between attitudes toward antipsychotic drug therapy, subjective well-being, and symptom change in patients with chronic schizophrenia...
June 28, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29911534/rituximab-treated-pemphigus-foliaceus-in-a-schizophrenic-patient-a-challenging-exercise-in-diagnosis-management-and-follow-up
#14
Nicholas A Ross, Miriam L Vega, Matthew S Keller
Dermatology was consulted in the care of a 58-year-old man with a history of paranoid schizophrenia, neuroleptic malignant syndrome, a positive purified protein derivative test, and a lack of bathing for approximately 4 years who had been admitted to the hospital because of thick, crusted lesions over an increasing portion of his body. Admitted involuntarily, he was disinterested in the history, physical examination, and diagnostic testing. Comorbid schizophrenia presented a unique challenge because he was unable to participate in his care effectively...
2018: Skinmed
https://www.readbyqxmd.com/read/29892970/olanzapine-as-a-cause-of-neuroleptic-malignant-syndrome-bibliographic-review-following-a-clinical-case
#15
Eva M García-Atienza, José L Agudo-Mena, Encarnación Cuesta-Vizcaíno, Carmen L Val-Jiménez, Miguel A Sáez-Moreno
No abstract text is available yet for this article.
May 2018: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/29891098/the-dissemination-of-the-french-school-of-psychiatry-and-its-impact-in-the-world
#16
S Richa, M Masson, S-P Tawil
The French School of Psychiatry has characteristics which are proper to it, and it conveys many notions related to health care, in addition to the accompaniment and the comprehension of mentally ill people and mental illness. These notions are specific to the French culture. Thus, famous French psychiatrists have described many syndromes and discovered the first neuroleptic, chlorpromazine. Among these psychiatrists: Pinel, Esquirol, Janet, Ey, Delay and Deniker. Furthermore, the first World Psychiatry Congress was held in Paris in 1950...
June 8, 2018: L'Encéphale
https://www.readbyqxmd.com/read/29866205/effects-of-dexmedetomidine-on-delirium-duration-of-non-intubated-icu-patients-4d-trial-study-protocol-for-a-randomized-trial
#17
Clémence Louis, Thomas Godet, Gérald Chanques, Nathalie Bourguignon, Dominique Morand, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: Delirium during intensive care unit (ICU) stay is frequent and associated with significant morbidity, mortality and healthcare-related costs. International guidelines suggest its prevention. However, curative treatment remains unclearly established. Despite contradictory and ambiguous academic literature, international guidelines suggest the use of second-generation (atypical) antipsychotics over haloperidol. However, haloperidol remains the most widely used neuroleptic worldwide as a first-line treatment of agitation and/or delirium...
June 4, 2018: Trials
https://www.readbyqxmd.com/read/29864758/electroconvulsive-therapy-general-considerations-and-experience-in-croatia
#18
Alma Mihaljević-Peleš, Maja Bajs Janović, Ana Stručić, Marina Šagud, Milena Skočić HanŽek, Maja Živković, Špiro Janović
Despite controversy, ECT has been recognized as significantly effective for the treatment of mental disorders since 1938, when Cerletti and Bini introduced ECT in clinical psychiatric practice for treatment of schizophrenia. In the next period, indication for ECT switched more toward depression and catatonia. ECT was even banned from psychiatric training in 1960's, due to the anti-psychiatric movement, which were fortified by Oscar winning movie "One Flew over the Cuckoo's Nest". Due to its robust effectiveness, ECT revived in the early 1980's and today holds its position in clinical psychiatric practices around the world...
June 2018: Psychiatria Danubina
https://www.readbyqxmd.com/read/29701436/-abnormal-movements-and-internal-medicine-pathologies
#19
Joseph Ghika
Hyperkinesias can be revelaed by an internal medicine pathology. An acute chorea can be found in association with non ketotic hypergycemia, lupus, antiphospholipid syndrome, endocrinopathies, pregnancy or oral contraceptive initiation, or psychostimulant medication. Acute dystonic syndromes are found in association with the initiation of an old generation neuroleptic, metoclopramide, oral contraceptive and pregnancy. It should be differentiated from hyper- or hypo-calcémie tetany. Tremors are found in association with many drugs and hormones...
April 25, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29698346/a-mixed-presentation-of-serotonin-syndrome-vs-neuroleptic-malignant-syndrome-in-a-12-year-old-boy
#20
Christie Sun, Hannah Sweet, Alicia B Minns, Desiree Shapiro, Willough Jenkins
BACKGROUND: Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. CASE: A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements...
April 24, 2018: Pediatric Emergency Care
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