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

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 in...

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Autores principales: Foguet-Boreu, Quintí, Coll-Negre, Montse, Serra-Millàs, Montse, Cavalleria-Verdaguer, Miquel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806498/
https://www.ncbi.nlm.nih.gov/pubmed/29441189
http://dx.doi.org/10.4081/cp.2018.1044
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author Foguet-Boreu, Quintí
Coll-Negre, Montse
Serra-Millàs, Montse
Cavalleria-Verdaguer, Miquel
author_facet Foguet-Boreu, Quintí
Coll-Negre, Montse
Serra-Millàs, Montse
Cavalleria-Verdaguer, Miquel
author_sort Foguet-Boreu, Quintí
collection PubMed
description 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.
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spelling pubmed-58064982018-02-13 Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion Foguet-Boreu, Quintí Coll-Negre, Montse Serra-Millàs, Montse Cavalleria-Verdaguer, Miquel Clin Pract Case Report 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. PAGEPress Publications, Pavia, Italy 2018-01-26 /pmc/articles/PMC5806498/ /pubmed/29441189 http://dx.doi.org/10.4081/cp.2018.1044 Text en ©Copyright Q. Foguet-Boreu et al., 2018 http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).
spellingShingle Case Report
Foguet-Boreu, Quintí
Coll-Negre, Montse
Serra-Millàs, Montse
Cavalleria-Verdaguer, Miquel
Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title_full Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title_fullStr Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title_full_unstemmed Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title_short Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
title_sort neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806498/
https://www.ncbi.nlm.nih.gov/pubmed/29441189
http://dx.doi.org/10.4081/cp.2018.1044
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