Neuroleptic malignant syndrome due to three atypical antipsychotics in a child

Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Bundang Hospital, Seoul, Korea.
Journal of Psychopharmacology (Impact Factor: 3.59). 08/2005; 19(4):422-5. DOI: 10.1177/0269881105053310
Source: PubMed


Neuroleptic Malignant Syndrome (NMS) is a rare, potentially fatal and idiosyncratic drug reaction. It is characterized by a sudden loss of body temperature control, renal and respiratory failure, muscle rigidity, loss of consciousness and impairment of autonomic nervous system. Although NMS was previously associated with the use of classical high-potency neuroleptics, cases have started to emerge with atypical neuroleptics. This article discusses the first case of NMS in a child, induced by the use of risperidone, olanzapine and quetiapine.

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    • "Some antipsychotic drugs modify the sympathetic and hyperthermic reactions due to orexin A. Indeed, an administration of haloperidol or clozapine respectively reduces or blocks these reactions (Monda et al., 2003b, 2004), while risperidone increases sympathetic and hyperthermic reactions induced by orexin A in the rat (Monda et al., 2006). Quetiapine, an atypical antipsychotic drug (NemeroV et al., 2002), can modify body temperature; in fact a sudden loss of body temperature control can be seen during the neuroleptic malignant syndrome (Chungh et al., 2005). There are evidences showing that chronic administration of quetiapine signiWcantly attenuates the amphetamine-induced hyperthermia (He et al., 2005). "
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    ABSTRACT: Since no experiment regarding a possible relation between quetiapine and orexin A has been reported in international literature, this experiment tested the effect of quetiapine on the sympathetic and thermogenic effects induced by orexin A. The firing rates of the sympathetic nerves to interscapular brown adipose tissue (IBAT), along with IBAT, colonic temperatures and heart rate were monitored in urethane-anesthetized male Sprague-Dawley rats before an injection of orexin A (1.5 nmol) into the lateral cerebral ventricle and over a period of 150 min after the injection. The same variables were monitored in rats with an intraperitoneal administration of quetiapine (5 or 10 mg/kg bw), injected 30 min before the orexin administration. The results show that orexin A increases the sympathetic firing rate, IBAT, colonic temperatures and heart rate. This increase is delayed or reduced by the injection of quetiapine. These findings indicate that quetiapine affects the complex reactions related to activation of orexinergic system. Possible influences on the control of body weight and temperature are discussed.
    Neuropeptides 11/2006; 40(5):357-63. DOI:10.1016/j.npep.2006.07.003 · 2.64 Impact Factor

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