背景:抗精神病药恶性综合征(NMS)是一种罕见且危及生命的反应。由于非典型抗精神病药的使用率较高,NMS的发病率有所下降,与典型的相比。服用可注射抗精神病药的患者的死亡率也达到了38%。
目标:这里,报告1例使用氟哌噻吨(FPX)后出现NMS症状.
方法:患者是一名46岁的男性,有分裂情感障碍(SAD)病史,最近服用了6周剂量的长效(LA)典型抗精神病药物。他被转介发烧,出汗,食物不耐受,mutism,2019年迷失方向。他表现出普遍的僵化,消极主义,颈部僵硬。患者的初始肌酸磷酸激酶(CPK)水平为1476IU/L,在第26天逐渐升高至3997IU/L。NMS被进一步诊断,根据精神疾病诊断和统计手册,第五版(DSM-5)标准,Naranjo算法中的9+分作为药物不良反应概率量表。之后,患者每天3次使用5毫克的溴隐亭治疗,逐渐达到最大50毫克。他经历了几次败血症和耐药性呼吸道感染。病人住院66天后终于出院,具有高度的意识,但是语言交流有限,在无发烧的情况下,口服溴隐亭和劳拉西泮。
结论:结论:对于接受LA注射抗精神病药物的患者的NMS管理挑战,有建议.
Neuroleptic malignant syndrome (NMS) is a rare and life-threatening reaction. The incidence rate of NMS has dropped because of the higher use of atypical antipsychotics, compared with the typical ones. The mortality rate in patients taking injectable antipsychotics has been also by 38%.
Here, a
case developing the NMS symptoms following Flupentixol (FPX) use was reported.
The patient was a 46-year-old man with the history of schizoaffective disorder (SAD) and recently on six-weekly doses of long-acting (LA) typical antipsychotic drugs. He was referred with a fever, sweating, a food intolerance, mutism, and disorientation in 2019. He was presented with generalized rigidity, negativism, and neck stiffness. The patient\'s initial creatine phosphokinase (CPK) level was 1476 IU/L, which gradually elevated to 3997 IU/L on Day 26. NMS was further diagnosed, in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, and the score 9+ in the Naranjo Algorithm as the adverse drug reaction probability scale. Afterward, the patient was treated with
bromocriptine at a dose of 5 mg 3 times a day, which progressively reached a maximum of 50 mg. He experienced sepsis and resistant respiratory infection several times. The
case was finally discharged after 66 days of hospitalization, with a high level of consciousness, but limited verbal communication, in a fever-free condition with the oral administration of
bromocriptine and lorazepam.
In conclusion, there were suggestions for the management challenges of NMS in patients receiving LA injectable antipsychotic agents.