A case of haloperidol induced neuroleptic malignant syndrome in postpartum psychosis: a rare case report and review of literature
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251995Keywords:
Neuroleptic malignant syndrome, Abruptio placentae, Hyperthermia, Creatine phosphokinaseAbstract
Neuroleptic malignant syndrome (NMS) is a very rare and fatal complication which occurs due to use of Neuroleptic agents in the treatment of psychotic disorders. Neuroleptic drugs are assumed to be safe for both mother and foetus owing to its relative impact on untreated fulminant psychosis. NMS was observed mostly after the use of high potency first generation neuroleptic agents such as haloperidol, fluphenazine, chlorpromazine. NMS is characterised by triad of fever, muscle rigidity and altered mental status. We report a case of 26 years old G2P1L1 pregnant woman presented with abruptio placentae and intrauterine foetal demise at 35 weeks of gestation. During postpartum period, she developed NMS due to usage of haloperidol for postpartum psychosis. In this case we achieved a prompt recovery by using bromocriptine and lorazepam.
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References
American Psychiatric Association: Diagnostic and statistical manual of mental disorders. American Psychiatric Association Publishing. Washington DC. 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
Modi S, Dharaiya D, Schultz L, Varelas P. Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality. Neurocrit Care. 2016;24(1):97-103. DOI: https://doi.org/10.1007/s12028-015-0162-5
Mittal M, Garcia P, Lee JP, Agustines D. A Case of Neuroleptic Malignant Syndrome in Pregnancy. Cureus. 2019;11(3):e4211. DOI: https://doi.org/10.7759/cureus.4211
Levenson JL. Neuroleptic malignant syndrome. Am J Psychiatry. 1985;142(10):1137-45. DOI: https://doi.org/10.1176/ajp.142.10.1137
Velamoor VR. Neuroleptic malignant syndrome: recognition, prevention and management. Drug Saf. 1998;19:73. DOI: https://doi.org/10.2165/00002018-199819010-00006
Spivak B, Maline DI, Vered Y, Kozyrev VN, Mester R, Neduva SA, et al. Prospective evaluation of circulatory levels of catecholamines and serotonin in neuroleptic malignant syndrome. Acta Psychiatr Scand. 2000;102(3):226-30. DOI: https://doi.org/10.1034/j.1600-0447.2000.102003226.x
Mihara K, Kondo T, Suzuki A, Yasui-Furukori N, Ono S, Sano A, et al. Relationship between functional dopamine D2 and D3 receptors gene polymorphisms and neuroleptic malignant syndrome. Am J Med Genet B Neuropsychiatr Genet. 2003;117B(1):57-60. DOI: https://doi.org/10.1002/ajmg.b.10025
Berardi D, Amore M, Keck PE Jr, Troia M, Dell'Atti M. Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: a case-control study. Biol Psychiatry. 1998;44(8):748-54. DOI: https://doi.org/10.1016/S0006-3223(97)00530-1
Caroff SN, Rosenberg H, Fletcher JE, Heiman-Patterson TD, Mann SC. Malignant hyperthermia susceptibility in neuroleptic malignant syndrome. Anesthesiology. 1987;67(1):20 DOI: https://doi.org/10.1097/00000542-198707000-00004
Pileggi DJ, Cook AM. Neuroleptic Malignant Syndrome: Focus on treatment and rechallenge. Ann Pharmacother. 2016;50(11):973-81. DOI: https://doi.org/10.1177/1060028016657553
Sakkas P, Davis JM, Janicak PG, Wang ZY. Drug treatment of the neuroleptic malignant syndrome. Psychopharmacol Bull. 1991;27(3):381-4. DOI: https://doi.org/10.3928/0048-5713-19910301-08
Kolb ME, Horne ML, Martz R. Dantrolene in human malignant hyperthermia. Anesthesiology. 1982;56(4):254-62. DOI: https://doi.org/10.1097/00000542-198204000-00005
Trollor JN, Sachdev PS. Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Aust N Z J Psychiatry. 1999;33(5):650-59. DOI: https://doi.org/10.1046/j.1440-1614.1999.00630.x
Lappa A, Podestà M, Capelli O, Castagna A, Di Placido G, Alampi D, et al. Successful treatment of a complicated case of neuroleptic malignant syndrome. Intensive Care Med. 2002;28(7):976. DOI: https://doi.org/10.1007/s00134-002-1241-6