Lamotrigine, quetiapine and aripiprazole-induced neuroleptic malignant syndrome in a patient with renal failure caused by lithium: a case report
| Autor: | Przemysław Grudzka, Aleksander Araszkiewicz, Anna Szota, Izabela Radajewska |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Olanzapine
Lithium (medication) medicine.drug_class lcsh:RC435-571 Aripiprazole Atypical antipsychotic Case Report Lamotrigine Lithium 03 medical and health sciences Quetiapine Fumarate 0302 clinical medicine lcsh:Psychiatry medicine Humans Neuroleptic Malignant Syndrome Renal Insufficiency Risperidone business.industry Quetiapine Middle Aged medicine.disease 030227 psychiatry Neuroleptic malignant syndrome Psychiatry and Mental health Anesthesia Female business 030217 neurology & neurosurgery medicine.drug Antipsychotic Agents |
| Zdroj: | BMC Psychiatry BMC Psychiatry, Vol 20, Iss 1, Pp 1-5 (2020) |
| ISSN: | 1471-244X |
| Popis: | Background Neuroleptic malignant syndrome (NMS) may be induced by atypical antipsychotic drugs (AAPDs) such as aripiprazole, olanzapine, risperidone and quetiapine, either as a single treatment or in combination with other drugs. A case of NMS following the administration of lamotrigine, aripiprazole and quetiapine in a patient with bipolar disorder, and with renal failure caused by toxic lithium levels has not been reported. Case presentation A 51-year-old female patient with a 27-year history of bipolar disorder, being treated with lithium, fluoxetine, olanzapine, gabapentine, perazine and biperiden, was admitted to the hospital due to depressed mood and delusions. A urinary tract infection was diagnosed and antibiotic therapy was initiated. After 5 days of treatment her physical state deteriorated and she developed a fever of 38.4 °C. Her laboratory results revealed a toxic level of lithium (2.34 mmol/l). Acute renal failure was diagnosed and the lithium was withdrawn. After stabilization of her condition, and despite her antipsychotic treatment, further intensification of delusions and depressed mood were observed. All drugs being taken by the patient were withdrawn and lamotrigine and aripiprazole were initiated. Due to the insufficient effectiveness of aripiprazole treatment and because of problems with sleep, quetiapine was added, however further treatment with this drug combination and an increase of quetiapine to 400 mg/d eventually caused NMS. Amantadine, lorazepam and bromocriptine were therefore initiated and the patient’s condition improved. Conclusion This case report indicates that concurrent use of multiple antipsychotic drugs in combination with mood stabilizers in patients with organic disorders confers an increased risk of NMS development. |
| Databáze: | OpenAIRE |
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