Neuroleptic malignant syndrome (NMS) is a rare complication of treatment with neuroleptics. The pathophysiology is not fully known. A dopaminergic transmission block in the basal ganglia and hypothalamus is thought to be the pathophysiological mechanism of NMS. Several cases of NMS have been reported, precipitated by medication without a direct effect on the dopaminergic system. This Medline analysis concerns 23 cases of antidepressant-induced NMS reported in the literature with the differing pathophysiological hypotheses on the precipitation of NMS. The results indicate no hard evidence of an antidepressant-evoked NMS. However, various hypotheses assuming an disturbed balance of the dopaminergic and non-dopaminergic system may be relevant in animal studies, but are without clinically relevant proof presently. An antidepressant-induced NMS is a very rare complication on the basis of pretreatment with neuroleptics causing chronic dopamine blockade and elevated plasma level of neuroleptics due to comedicated antidepressants.
"The similar syndromes have also been reported to be caused by numerous other classes of drugs with different mechanisms of action [e.g., lithium, clomipramine, nortryptiline, SSRIs, benzodiazepines] (Kellam, 1987a; Ananth et al., 2004a, but see also Assion et al., 1998), and even in the absence of any pharmacotherapeutic intervention (the so-called lethal catatonia), and thus some researchers have commented that NMS is a misnomer (Singh & Maguire, 1987; Brennan et al., 1988). They proposed novel names such as " iatrogenic malignant syndrome " (Singh & Maguire, 1987) or " pyrexial catatonia " (Kellam, 1987b) instead of NMS. "
[Show abstract][Hide abstract] ABSTRACT: The maintenance of CAPE-OPEN compliant process modelling components is a complex task. It requires accurate knowledge about three interconnected domains: the process itself, the CAPE-OPEN interfaces specification, and the middleware (COM, CORBA, and NET). Consequently, maintenance tasks require the collaboration of several experts throughout the entire component lifecycle. Tools that assist experts in performing these tasks are thus required. This paper presents a tool that embeds enough knowledge about these three aspects, to automatically generate compliant code. Our approach is a software factory that takes as inputs three separated models describing: the process modelling component, the standard specification, and the middleware. These models are combined and refined using successive model transformations, until code is generated. In order to anticipate the evolution of the three domains, transformations are expressed on stable abstractions with respect to expected changes.
Computer Aided Chemical Engineering DOI:10.1016/S1570-7946(09)70255-X
[Show abstract][Hide abstract] ABSTRACT: We report here an autopsy case of a 49-year-old woman with depression who died of hyperthermia, probably due to amitriptyline intoxication. She was found dead in bed with several empty amitriptyline pill containers. Her rectal temperature was 41.5 degrees C approximately 3 hours after death. Plasma levels of amitriptyline and nortriptyline were 0.51 and 0.74 mg/l, respectively. Possible mechanisms of fatal hyperthermia are discussed.
Legal Medicine 11/2000; 2(3):152-5. DOI:10.1016/S1344-6223(00)80015-2 · 1.24 Impact Factor
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