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A Typical Neuroleptic Malignant Syndrome Presenting with Hyponatremia

Medicine Group    Start Submission

Rustem O*, Ercan Y and Ozer O

Volume6-Issue8
Dates: Received: 2025-06-26 | Accepted: 2025-08-13 | Published: 2025-08-27
Pages: 1138-1142

Abstract

Neuroleptic Malignant Syndrome (NMS) is a rare but potentially fatal neurological complication of medications affecting the central dopaminergic system, especially antipsychotic agents. According to one theory, decreased dopamine activity in the central nervous system plays a role in the pathogenesis of NMS. Clinically, patients exhibit resistant fever, neurological and autonomic findings, and laboratory changes. In this article, we aimed to present a case of neuroleptic malignant syndrome due to a single dose of venlafaxine, which presented with hyponatremia and high fever.

FullText HTML FullText PDF DOI: 10.37871/jbres2171


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© 2025 Rustem O, et al. Distributed under Creative Commons CC-BY 4.0

How to cite this article

Rustem O, Ercan Y, Ozer O. A Typical Neuroleptic Malignant Syndrome Presenting with Hyponatremia. J Biomed Res Environ Sci. 2025 Aug 27; 6(8): 1138-1142. doi: 10.37871/jbres2171, Article ID: JBRES2171, Available at: https://www. jelsciences.com/articles/jbres2171.pdf


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References


  1. Erol A, Putgül G, Sert E, Mete L. Klozapin kullanımına bağlı nöroleptik malign sendrom ve ardışık katatoni: olgu sunumu [Clozapine-associated neuroleptic malignant syndrome followed by catatonia: a case report]. Turk Psikiyatri Derg. 2013 Summer;24(2):140-4. Turkish. PMID: 23754268.
  2. Kasantikul D, Kanchanatawan B. Neuroleptic malignant syndrome: a review and report of six cases. J Med Assoc Thai. 2006 Dec;89(12):2155-60. PMID: 17214072.
  3. Tse L, Barr AM, Scarapicchia V, Vila-Rodriguez F. Neuroleptic Malignant Syndrome: A Review from a Clinically Oriented Perspective. Curr Neuropharmacol. 2015;13(3):395-406. doi: 10.2174/1570159x13999150424113345. PMID: 26411967; PMCID: PMC4812801.
  4. Sarkar P, Natarajan C, Gode N. Prevalence of neuroleptic malignant syndrome in 672 consecutive male in-patients. Indian J Psychiatry. 2009 Jul-Sep;51(3):202-5. doi: 10.4103/0019-5545.55089. PMID: 19881049; PMCID: PMC2772217.
  5. Gurrera RJ. A systematic review of sex and age factors in neuroleptic malignant syndrome diagnosis frequency. Acta Psychiatr Scand. 2017 May;135(5):398-408. doi: 10.1111/acps.12694. Epub 2017 Feb 1. PMID: 28144982.
  6. Pileggi DJ, Cook AM. Neuroleptic Malignant Syndrome. Ann Pharmacother. 2016 Nov;50(11):973-981. doi: 10.1177/1060028016657553. Epub 2016 Jul 19. PMID: 27423483.
  7. Xi A, Royce-Nagel G. 160: Treatment and complications of neuroleptic malignant syndrome. Critical Care Medicine. 2019;47(1):62. doi: 10.1097/01.ccm.0000550915.79019.18.
  8. Modi S, Dharaiya D, Schultz L, Varelas P. Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality. Neurocrit Care. 2016 Feb;24(1):97-103. doi: 10.1007/s12028-015-0162-5. PMID: 26223336.
  9. Oruch R, Pryme IF, Engelsen BA, Lund A. Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatr Dis Treat. 2017 Jan 16;13:161-175. doi: 10.2147/NDT.S118438. PMID: 28144147; PMCID: PMC5248946.
  10. Nagel M, Freisberg S, Junghanns K, Moll CK, Willenborg B. Das maligne neuroleptische Syndrom (MNS)--Eine systematische Übersicht [The Neuroleptic Malignant Syndrome]. Fortschr Neurol Psychiatr. 2015 Jul;83(7):373-80. German. doi: 10.1055/s-0035-1553246. Epub 2015 Jul 22. PMID: 26200042.
  11. Doğan N, Kürşad H, Erdem AF, kızılkaya M. Noroleptik malign sendromda nadir etyolojikfaktorlerveklinikseyir. AUTD 2003;35:23-6.
  12. Buckley PF, Hutchinson M. Neuroleptic malignant syndrome. J Neurol Neurosurg Psychiatry. 1995 Mar;58(3):271-3. doi: 10.1136/jnnp.58.3.271. PMID: 7897404; PMCID: PMC1073359.
  13. Strawn JR, Keck PE Jr, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry. 2007 Jun;164(6):870-6. doi: 10.1176/ajp.2007.164.6.870. PMID: 17541044.
  14. Chandran GJ, Mikler JR, Keegan DL. Neuroleptic malignant syndrome: case report and discussion. CMAJ. 2003 Sep 2;169(5):439-42. PMID: 12952806; PMCID: PMC183299.
  15. Stevens DL. Association between selective serotonin-reuptake inhibitors, second-generation antipsychotics, and neuroleptic malignant syndrome. Ann Pharmacother. 2008 Sep;42(9):1290-7. doi: 10.1345/aph.1L066. Epub 2008 Jul 15. PMID: 18628446.
  16. İşeri P, Selekler M. Nöroleptik malign sendrom. TurkiyeKlinikleri J Int Med Sci. 2005;1(5):39-42.
  17. Lang FU, Lang S, Becker T, Jäger M. Neuroleptic malignant syndrome or catatonia? Trying to solve the catatonic dilemma. Psychopharmacology (Berl). 2015 Jan;232(1):1-5. doi: 10.1007/s00213-014-3807-8. Epub 2014 Nov 20. PMID: 25407348.
  18. Portel L, Hilbert G, Gruson D, Favier JC, Gbikpi-Benissan G, Cardinaud JP. Malignant hyperthermia and neuroleptic malignant syndrome in a patient during treatment for acute asthma. Acta Anaesthesiol Scand. 1999 Jan;43(1):107-10. doi: 10.1034/j.1399-6576.1999.430123.x. PMID: 9926200.
  19. Sangal R, Dimitrijevic R. Neuroleptic malignant syndrome. Successful treatment with pancuronium. JAMA. 1985 Nov 15;254(19):2795-6. PMID: 4057490.
  20. Pierantozzi M, Sabato AF, Leonardis F, Marciani MG, Cicardi C, Giacomini P, Bernardi G, Stanzione P. Curariform peripheral block of muscular tone selectively increases precentral N30 somatosensory evoked potentials component. A pharmacological study carried out on healthy subjects and parkinsonian syndromes. Exp Brain Res. 2000 Aug;133(3):368-76. doi: 10.1007/s002210000387. PMID: 10958527.
  21. Gurrera RJ. Sympathoadrenal hyperactivity and the etiology of neuroleptic malignant syndrome. Am J Psychiatry. 1999 Feb;156(2):169-80. doi: 10.1176/ajp.156.2.169. PMID: 9989551.
  22. Mills EM, Banks ML, Sprague JE, Finkel T. Pharmacology: uncoupling the agony from ecstasy. Nature. 2003 Nov 27;426(6965):403-4. doi: 10.1038/426403a. PMID: 14647371.
  23. Blessing WW, Seaman B, Pedersen NP, Ootsuka Y. Clozapine reverses hyperthermia and sympathetically mediated cutaneous vasoconstriction induced by 3,4-methylenedioxymethamphetamine (ecstasy) in rabbits and rats. J Neurosci. 2003 Jul 16;23(15):6385-91. doi: 10.1523/JNEUROSCI.23-15-06385.2003. PMID: 12867524; PMCID: PMC6740548.
  24. Zaretsky DV, Zaretskaia MV, Durant PJ, Rusyniak DE. Inhibition of the dorsomedial hypothalamus, but not the medullary raphe pallidus, decreases hyperthermia and mortality from MDMA given in a warm environment. Pharmacol Res Perspect. 2014 Apr 1;2(2):e00031. doi: 10.1002/prp2.31. PMID: 24765530; PMCID: PMC3994179.
  25. Pedersen NP, Blessing WW. Cutaneous vasoconstriction contributes to hyperthermia induced by 3,4-methylenedioxymethamphetamine (ecstasy) in conscious rabbits. J Neurosci. 2001 Nov 1;21(21):8648-54. doi: 10.1523/JNEUROSCI.21-21-08648.2001. PMID: 11606652; PMCID: PMC6762811.
  26. Rusyniak DE, Sprague JE. Toxin-induced hyperthermic syndromes. Med Clin North Am. 2005 Nov;89(6):1277-96. doi: 10.1016/j.mcna.2005.06.002. Erratum in: Med Clin North Am. 2006 Jan;90(1):261-2. PMID: 16227063.
  27. Rosebush PI, Anglin RE, Richards C, Mazurek MF. Neuroleptic malignant syndrome and the acute phase response. J Clin Psychopharmacol. 2008 Aug;28(4):459-61. doi: 10.1097/JCP.0b013e31817ea9c1. PMID: 18626278.
  28. Zaretsky DV, Hunt JL, Zaretskaia MV, DiMicco JA. Microinjection of prostaglandin E2 and muscimol into the preoptic area in conscious rats: comparison of effects on plasma adrenocorticotrophic hormone (ACTH), body temperature, locomotor activity, and cardiovascular function. Neurosci Lett. 2006 Apr 24;397(3):291-6. doi: 10.1016/j.neulet.2005.12.032. Epub 2006 Jan 6. PMID: 16406311.
  29. Baltacıoğlu M, Hocaoğlu Ç. Nöroleptik malign sendromnedir? Tanıvetedaviyaklaşımları. Journal of contemporary medicine. 2019;9(4):424-431
  30. Rosebush P, Stewart T. A prospective analysis of 24 episodes of neuroleptic malignant syndrome. Am J Psychiatry. 1989 Jun;146(6):717-25. doi: 10.1176/ajp.146.6.717. PMID: 2567121.
  31. Lu TC, Chu PL, Wu CS, Tsai KC, Chen WJ. Neuroleptic malignant syndrome after the use of venlafaxine in a patient with generalized anxiety disorder. J Formos Med Assoc. 2006 Jan;105(1):90-3. doi: 10.1016/S0929-6646(09)60115-7. PMID: 16440077.
  32. Kösem B. TekdozvenlafaksinkullanımınabağlıgelişenNöroleptik malign sendrom. Yeni Tıp Dergisi. 2014.
  33. Woods G, Taggart C, Boggs R, Cadden I. Neuroleptic malignant syndrome associated with quetiapine and venlafaxine use: a case report and discussion. Ther Adv Psychopharmacol. 2013 Feb;3(1):53-5. doi: 10.1177/2045125312464386. PMID: 23983992; PMCID: PMC3736958.


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