scholarly journals Neuroleptic Malignant Syndrome (NMS) on Clozapine with a Potential Atypical Interaction with Paliperidone

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Paras Agarwal ◽  
Adanegbe Omoruyi ◽  
Kiara Gascon Perai ◽  
Kerenza MacDaid ◽  
Andrea Burton
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
First Generation ◽  
Idiosyncratic Reaction ◽  
Statistical Manual ◽  
Diagnostic Uncertainty ◽  
Diagnostic And Statistical Manual ◽  
Core Symptom ◽  
Second Generation Antipsychotics ◽  
Criteria For Diagnosis ◽  
Minor Criteria

Neuroleptic Malignant Syndrome (NMS) associated with the use of first-generation antipsychotics is a widely known phenomenon. This idiosyncratic reaction is less significant with the use of second-generation antipsychotics, and only a few cases in the literature exist, describing this reaction with clozapine use. While being titrated on clozapine, the patient developed major and minor criteria features of NMS as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5) criteria except for fever, a core symptom which created diagnostic uncertainty. Initially, clozapine was temporarily discontinued due to his deteriorating mental and physical state. A rechallenge was considered at a much lower dose, but due to a rapid increase in his creatinine kinase (CK) levels within a 12-hour timeframe, clozapine was permanently stopped. The evidence further suggests that the presentation of NMS for patients on this medication may be different to the classical presentation, and other criteria for diagnosis are suggested, which may lower the threshold for investigating NMS for patients on clozapine.

scholarly journals Developmental coordination disorder DCD – terminology, diagnosis and intervention. The implication for speech therapy.

2020 ◽  
Vol VI (2) ◽  
pp. 101-121
Author(s):  
Raluca Nicoleta TRIFU
Keyword(s):  
Speech Therapy ◽  
Developmental Coordination Disorder ◽  
Motor Planning ◽  
Motor Dysfunction ◽  
Fine Motor ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Icd 10 ◽  
Criteria For Diagnosis ◽  
Coordination Disorder

Developmental coordination disorder DCD is a specific set of impairments corelated with gross and fine motor disfunction, poor motor planning and impaired sensor integration. The term is use wildly for this condition, based on the proposed term made by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), but others terms such as dyspraxia, specific motor dysfunction, specific coordination motor disfunction (ICD – 10) are used and preferred in the same time. The article displays the multiple terms used in the literature connected with the DCD, the criteria for diagnosis, the implication for education and target specific intervention in case of DCD.

An Analysis of 17 Catatonic Patients Diagnosed With Neuroleptic Malignant Syndrome

CNS Spectrums ◽  
2000 ◽  
Vol 5 (7) ◽  
pp. 58-65 ◽  
Author(s):  
Denise A. C. White ◽  
Ashley H. Robins
Keyword(s):  
Single Dose ◽  
Mental Disorders ◽  
Medical Treatment ◽  
Neuroleptic Malignant Syndrome ◽  
Creatine Phosphokinase ◽  
Predisposing Factor ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Before And After ◽  
Neuroleptic Administration

AbstractThis study was conducted to show that catatonia is a predisposing factor for neuroleptic malignant syndrome (NMS) and to review the nosological relationship between catatonia and NMS. Seventeen consecutive cases of NMS were analyzed prospectively with reference to clinical and investigative findings before and after exposure to a neuroleptic. The series comprised eight males and nine females, ranging in age from 18 years to 65 years. Prior to neuroleptic exposure, all patients exhibited features compatible with criteria for catatonia (mutism/excitement) according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised, (DSM-III-R). Following neuroleptic administration (single dose in nine cases), patients deteriorated into a febrile, rigid, and obtunded state accompanied by autonomic dysfunction and raised creatine phosphokinase levels. These features were consistent with a diagnosis of NMS. Neuroleptics were discontinued and supportive medical treatment instituted. Benzodiazepines were beneficial in eight cases in relieving stupor, but bromocriptine and dantrolene were generally ineffective. In all patients diagnosed with NMS in the authors' series, catatonia was an invariable prodromal state. It appears that the administration of a neuroleptic intensified the preexisting catatonic state and precipitated a malignant variant of the disorder, which is currently recognized as NMS. The authors, therefore, challenge the separate nosological status of NMS and catatonia and suggest that these syndromes are part of a unitary pathophysiological disorder.

Is Lorazepam a Treatment for Neuroleptic Malignant Syndrome?

CNS Spectrums ◽  
2000 ◽  
Vol 5 (7) ◽  
pp. 54-57 ◽  
Author(s):  
Andrew Francis ◽  
Sanjay Chandragiri ◽  
Syed Rizvi ◽  
Monika Koch ◽  
Georgios Petrides
Keyword(s):  
Mental Disorders ◽  
Hospital Admission ◽  
Neuroleptic Malignant Syndrome ◽  
Recovery Time ◽  
Clinical Signs ◽  
Fourth Edition ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm Iv ◽  
Research Criteria

AbstractThe authors assessed the ability of lorazepam and other benzodiazepines to affect the course of neuroleptic malignant syndrome (NMS). Records of inpatients who met both stringent research criteria and criteria under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) (n=11) or DSM-IV criteria alone (n=5)for NMS were identified. All received lorazepam or related benzodiazepines within 24 hours of NMS onset or hospital admission. The records were reviewed for resolution of clinical signs NMS. Rigidity and fever abated within 24—48 hours, while secondary features of NMS were relieved within 64 hours. These results compared favorably with prior reports of 5-day to 10-day recovery periods. Benzodiazepine administration appeared to be well tolerated. Lorazepam and related benzodiazepines may reduce recovery time in NMS.

scholarly journals Early detection of an atypical presentation of neuroleptic malignant syndrome: A case report

2017 ◽  
Vol 7 (3) ◽  
pp. 137-142
Author(s):  
P. Brittany Vickery ◽  
Lindsy Meadowcraft ◽  
Stephen B. Vickery
Keyword(s):  
Case Report ◽  
Mental Disorders ◽  
Neuroleptic Malignant Syndrome ◽  
Dopamine Antagonist ◽  
Atypical Presentation ◽  
Diagnostic Features ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Neurologic Emergency ◽  
Rapid Conversion

Abstract Neuroleptic malignant syndrome (NMS), which is considered a neurologic emergency, is believed to be caused by exposure to dopamine antagonist or withdrawal from a dopamine agonist. This article reports a case of suspected atypical NMS in a patient following rapid conversion of ziprasidone to risperidone without titration. While the initial presentation did not fully meet the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic features, a sequential treatment strategy was initiated and the patient appropriately responded to antipsychotic cessation in addition to combination therapy with dantrolene and bromocriptine. Neuroleptic malignant syndrome diagnostic criteria, treatment, and prognosis are discussed.

Neuroleptic Malignant Syndrome: A Pilot Study on Psychiatric Inpatients in Iran

2019 ◽  
Vol 8 (3) ◽  
pp. 207-212
Author(s):  
Saeed S. Shafti ◽  
Alireza Memarie ◽  
Masomeh Rezaie ◽  
Masomeh Hamidi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
First Generation ◽  
Second Generation ◽  
Psychiatric Patients ◽  
Statistical Significance ◽  
P Value ◽  
Antipsychotic Treatment ◽  
Second Generation Antipsychotics ◽  
Significant Difference ◽  
Male Patients

Background: Neuroleptic malignant syndrome is a life-threatening complication that can occur anytime during antipsychotic treatment. Objective: The present assessment has probed the incidence and clinical profile of neuroleptic malignant syndrome among a sample of non-western psychiatric patients and compared with the available data in the literature with regard to prevalence and other associated clinical physiognomies. Methods: As a retrospective, record-based evaluation, all cases with diagnosis of neuroleptic malignant syndrome during the last sixty-two months, after ruling out other imaginable differential diagnoses, like encephalitis, meningitis and serotonin syndrome, entered the present investigation. Clinical diagnosis, was in essence also based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The assessment of independent variables was analyzed by ‘Compression of proportions’. Statistical significance is, defined as p value ≤0.05. Results: Among 19814 psychiatric patients, during a sixty-two months’ period, eighteen cases received the diagnosis of neuroleptic malignant syndrome. The most prevalent symptom was fever, which was observed in 100% of cases. Also, there was no significant difference between the first generation versus second-generation antipsychotics. Neuroleptic malignant syndrome was meaningfully more prevalent among male patients suffering from schizophrenia. Similarly, it was significantly more widespread amid 18-65 years old agegroup. Conclusion: While no significant difference was found between first-generation as opposed to second-generation antipsychotics, neuroleptic malignant syndrome was significantly more prevalent among young and male patients suffering from schizophrenia.

Neuroleptic Malignant Syndrome: No Longer Exclusively a “Neuroleptic” Phenomenon

2005 ◽  
Vol 21 (5) ◽  
pp. 262-270 ◽  
Author(s):  
Kurt A Wargo ◽  
Rahul Gupta
Keyword(s):  
Diagnostic Criteria ◽  
Neuroleptic Malignant Syndrome ◽  
First Generation ◽  
Second Generation ◽  
Case Reports ◽  
Data Extraction ◽  
Study Selection ◽  
Minor Criterion ◽  
Second Generation Antipsychotics ◽  
Review Reports

Objective: To review the literature concerning the incidence of neuroleptic malignant syndrome (NMS) associated with the use of atypical antipsychotics. Data Sources: Cases were identified through a search of MEDLINE (1986–March 2004) using the terms neuroleptic malignant syndrome, antipsychotic, clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole. Study Selection and Data Extraction: Case reports of possible NMS secondary to second-generation antipsychotics were selected for review. Reports meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for NMS were considered. Case reports in which 1 of the 2 major diagnostic criteria was met were also included in the analysis. Furthermore, at least one minor criterion was met. Case reports in which patients received traditional antipsychotics were excluded. Data Synthesis: NMS is a rare and sometimes fatal disease. Several theories exist as to how NMS develops, and an equally large amount of diagnostic criteria are available. However, the majority of available data are based on the first-generation neuroleptics and very few exist with regard to the second-generation antipsychotics. Conclusions: Although there are numerous case reports of NMS occurring secondary to the use of second-generation antipsychotics, the incidence has never been fully elucidated. While the reasons for this remain uncertain, not all cases of second-generation–induced NMS fulfill the diagnostic criteria established for traditional neuroleptics and therefore may not be reported as such.

Neuroleptic Malignant Syndrome and Hyperthermia

2019 ◽  
pp. 472-474
Author(s):  
J. Ross Renew ◽  
Monica Mordecai
Keyword(s):  
Creatine Kinase ◽  
Neuroleptic Malignant Syndrome ◽  
Clinical Symptoms ◽  
Altered Mental Status ◽  
Serum Creatine Kinase ◽  
Muscle Rigidity ◽  
Antipsychotic Medications ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Fatal Reaction

Neuroleptic malignant syndrome (NMS) is an uncommon, potentially fatal reaction to antipsychotic medications. Most cases occur in men between the ages of 20 and 50 because they have the highest proportion of antipsychotic consumption. The prevalence of NMS has been reported as 0.07% to 2.2%, but the published diagnostic criteria for NMS varied widely until the Diagnostic and Statistical Manual of Mental Disorders addressed the issue in 2013. NMS is characterized by a constellation of clinical symptoms and laboratory abnormalities, including hyperthermia, muscle rigidity, and increased serum creatine kinase levels. Patients may also present with tremor, altered mental status, autonomic dysfunction, and leukocytosis.

Clinical Characteristics of Cannabis Use Disorder

2018 ◽  
pp. 72-90
Author(s):  
Tammy A. Chung ◽  
Ken C. Winters
Keyword(s):  
Clinical Characteristics ◽  
Signs And Symptoms ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
The Core ◽  
Treatment Gaps ◽  
Other Substances ◽  
Criteria For Diagnosis

This chapter reviews the signs and symptoms of cannabis use disorder (CUD). Core clinical characteristics of addiction as reflected by the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) apply to cannabis, although certain substance use disorder symptoms are less salient to cannabis relative to other substances. The chapter addresses cannabis use prevalence, onset and progression of cannabis use, and heterogeneity in the course of cannabis use. The core features of addiction and the DSM CUD diagnosis are described with reference to the prevalence of CUD based on the fourth edition of the DSM, differences between the fourth and fifth editions for the criteria for diagnosis, and DSM-based cannabis symptoms. The course of CUD and remission and recovery from CUD are also addressed. The chapter closes with a discussion of research and treatment gaps.

scholarly journals Neuroleptic malignant syndrome: clinical expression, complication, course, and atypical clinical picture

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Bouchra Oneib ◽  
Ouafae Zaimi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Early Recognition ◽  
Psychiatric Service ◽  
Clinical Expression ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm V ◽  
Long Acting ◽  
First Time ◽  
Injectable Form

Abstract Background Neuroleptic malignant syndrome (NMS) is an uncommon and lethal side effect of neuroleptics. The clinical expression of this syndrome is diverse. Even with criteria diagnosis, it is hard to recognize it easily. We report a series of 25 cases of NMS among patients hospitalized in psychiatric service at Oujda for 5 years. We have described the clinical characteristics of NMS in these patients, the treatments received, the management, and the course of this syndrome. Results Most of the patients are hospitalized for psychotic or affective disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria. 92% of patients received conventional neuroleptic, and half of them were under the injectable form. No patient took long-acting injectable antipsychotics. 36% of patients received neuroleptics for the first time. NMS appeared in the first week after the admission in psychiatric service among 24 patients. The most common clinical and biological signs were muscular rigidity, the elevation of creatine phosphokinase (CPK), and alteration of blood pressure. Other symptoms were found in proportion varied between 24% and 72%. 32% of the patients did not develop complications. One patient developed renal failure. All patients recovered, and no deaths were recorded. Conclusions Early recognition of NMS help to rescue patient. It is necessary to detect this syndrome even in the absence of main signs such as fever.

Comparison of Alcohol Use Disorders in DSM and ICD

2020 ◽  
Vol 66 (3) ◽  
pp. 143-153
Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss
Keyword(s):  
Alcohol Use Disorders ◽  
International Classification Of Diseases ◽  
Clinical Use ◽  
Diagnostic Systems ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Historical Developments

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.

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