scholarly journals Hyperthermia syndromes in psychiatry

2009 ◽  
Vol 15 (3) ◽  
pp. 181-191 ◽  
Author(s):  
Niraj Ahuja ◽  
Andrew J. Cole
Keyword(s):  
Drug Treatment ◽  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Serotonin Syndrome ◽  
Systematic Approach ◽  
Psychiatric Patients ◽  
Initial Diagnosis ◽  
Malignant Hyperpyrexia ◽  
Malignant Catatonia

SummaryPresence of fever in psychiatric patients may signify a number of potentially fatal conditions. Several of these are related to treatments (e.g. neuroleptic malignant syndrome with antipsychotics, serotonin syndrome with serotonergic antidepressants, and malignant hyperpyrexia with anaesthesia used for administration of electroconvulsive therapy) or exacerbated by them (e.g. malignant catatonia with antipsychotics). New classes of drug treatment may be changing the epidemiology of these disorders. We suggest that an initial diagnosis of hyperthermia syndrome is clinically useful as there are some important commonalities in treatment. We outline a systematic approach to identify a particular subtype of hyperthermia syndrome and the indications for more specific treatments where available.

Neuroleptic malignant syndrome and delirious mania as malignant catatonia in autism: prompt relief with electroconvulsive therapy

2015 ◽  
Vol 132 (4) ◽  
pp. 319-320 ◽  
Author(s):  
L. Wachtel ◽  
E. Commins ◽  
M. Park ◽  
N. Rolider ◽  
R. Stephens ◽  
...  
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Malignant Catatonia

Heat stroke during treatment with olanzapine, trihexyphenidyl, and trazodone in a patient with schizophrenia

2015 ◽  
Vol 27 (6) ◽  
pp. 380-385 ◽  
Author(s):  
Chin-Pang Lee ◽  
Pei-Jung Chen ◽  
Chia-Ming Chang
Keyword(s):  
Intensive Care ◽  
Medical Treatment ◽  
Neuroleptic Malignant Syndrome ◽  
Maintenance Treatment ◽  
Serotonin Syndrome ◽  
Preventive Measures ◽  
Psychiatric Patients ◽  
Heat Stroke ◽  
Medical Emergency ◽  
Case Description

ObjectiveHeat stroke is a medical emergency. Psychiatric patients are particularly susceptible to heat stroke. Therefore, awareness and preventive measures of heat stroke are important for both clinicians and patients.Case descriptionA 49-year-old man with schizophrenia, who was under maintenance treatment with olanzapine 20 mg/day, trihexyphenidyl 4 mg/day, and trazodone 50 mg/day, suffered from heat stroke in a heat wave and required intensive care. He recovered with the medical treatment provided.DiscussionSeveral factors could have contributed to the impaired thermoregulation and the occurrence of heat stroke in this case: schizophrenia, the psychotropic regimen, and lack of preventive measures. Possible differential diagnoses of heat stroke in this case include infection, neuroleptic malignant syndrome, and serotonin syndrome.ConclusionHeat stroke can occur during the maintenance treatment of olanzapine, trihexyphenidyl, and trazodone for schizophrenia. Clinicians should be proactive to reduce the risk of heat stroke in psychiatric patients.

scholarly journals Case of refractory delirious mania responsive to lithium

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Manuel Pereira Herrera ◽  
Aphrodite Marta Zimmerman
Keyword(s):  
Bipolar Disorder ◽  
Valproic Acid ◽  
Neuroleptic Malignant Syndrome ◽  
Serotonin Syndrome ◽  
The Other ◽  
Minimal Improvement ◽  
History Of ◽  
Uncommon Condition ◽  
High Doses ◽  
Malignant Catatonia

Delirious mania is an uncommon condition that is challenging to diagnose and treat. More often seen in patients with a history of bipolar disorder, it frequently presents with prominent catatonic features and overlaps with other diseases in the catatonic spectrum, such as neuroleptic malignant syndrome, serotonin syndrome and malignant catatonia. We present a case of delirious mania refractory to high doses of lorazepam, several antipsychotics and valproic acid, which responded dramatically to therapy with lithium after 26 days of minimal improvement with the other medications. The pathophysiology of delirious mania is reviewed, and the unique actions of lithium are discussed, highlighting possible reasons as to why lithium might offer advantages in the treatment of this disease.

scholarly journals Diagnostic, Treatment, and System Challenges in the Management of Recurrent Neuroleptic Malignant Syndrome on a General Medical Service

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Karan Verma ◽  
Vivek Jayadeva ◽  
Raymond Serrano ◽  
Karthik Sivashanker
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Medical Service ◽  
Clinical Course ◽  
General Medical Service ◽  
Psychiatric Ward ◽  
High Morbidity ◽  
Intervention Protocol ◽  
Delayed Recognition ◽  
Malignant Catatonia

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. We educated our inpatient colleagues for timely recognition of hyperexcited subtype of catatonia to avoid iatrogenic progression to neuroleptic malignant syndrome and our medical colleagues on the clinical course of catatonic symptoms to avoid any further disagreements and delays in treatment. We advocated for timely electroconvulsive therapy in the setting of limited access and utilized creative pharmacologic strategies such as N-methyl-D-aspartate (NMDA) receptor antagonists and longer acting benzodiazepines while managing medical complications.

Medical Problems of Geriatric Psychiatric Patients and Younger Controls During Electroconvulsive Therapy

1984 ◽  
Vol 32 (9) ◽  
pp. 651-654 ◽  
Author(s):  
George S. Alexopoulos ◽  
Charles J. Shamoian ◽  
John Lucas ◽  
Neil Weiser ◽  
Henry Berger
Keyword(s):  
Electroconvulsive Therapy ◽  
Psychiatric Patients ◽  
Medical Problems

scholarly journals Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion

2018 ◽  
Author(s):  
Quintí Foguet-Boreu ◽  
Montse Coll-Negre ◽  
Montse Serra-Millàs ◽  
Miquel Cavalleria-Verdaguer
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Potential Role ◽  
Caucasian Woman ◽  
Concomitant Treatment ◽  
Pharmacological Treatments ◽  
Severe Motor ◽  
Autonomic Instability ◽  
History Of ◽  
Psychotic Features

Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT. The symptoms that had motivated the admission gradually remitted and the patient was discharged home. Bupropion increases dopaminergic activity in both the nucleus accumbens and the prefrontal cortex. Therefore, from a physiopathological standpoint, bupropion has a potential role in treating NMS. However, there is scarce evidence supporting this approach and therefore future cases should be carefully considered.

scholarly journals Effects of adding dexmedetomidine to ketamine on heart rate and blood pressure changs in psychiatric patients undergoing electroconvulsive therapy

2020 ◽  
Vol 22 (2) ◽  
pp. 311-316
Author(s):  
Behzad Nazemroaya ◽  
Azim Honarmand ◽  
Marzieh Bab Hadi Ashar ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Electroconvulsive Therapy ◽  
Psychiatric Patients
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