Hyperthermia, or extreme elevations in body temperature, can be life-threatening and may be caused by prescription drugs or illegal substances acting at a number of different levels of the neuraxis. Several psychotropic drug classes and combinations have been associated with a classic clinical syndrome of hyperthermia, skeletal muscle hypermetabolism, rigidity or rhabdomyolysis, autonomic dysfunction and altered mental status ranging from catatonic stupor to coma.
Hyperthermic reactions, though rare, can occur with any antipsychotic. Knowing the risk factors and early warning signs remains important to protecting your patients.
Neural circuit changes help explain syndrome’s signs, suggest potential therapies.
After 30 years, Mr. S’ catatonic schizophrenia finally responds to medication, but the drug causes a precipitous WBC decrease. The challenge: find a tolerable yet effective regimen.
The authors report three cases of neuroleptic malignant syndrome (NMS) induced by atypical antipsychotics (olanzapine and clozapine) which showed classic features of NMS including muscular rigidity and prominent fever.