Neuroleptic malignant syndrome in an elderly patient with bipolar disorder
Neuroleptic malignant syndrome (NMS) is a well-known and potentially fatal complication of antipsychotic use. The elderly population, with multiple risk factors, are more vulnerable to this condition. We described a case of an 80-year-old man with bipolar disorder, previously on oral extended-re...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Pusat Perubatan Universiti Kebangsaan Malaysia
2021
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| Online Access: | http://journalarticle.ukm.my/18284/ http://journalarticle.ukm.my/18284/1/22_ms0411_pdf_84231.pdf |
| _version_ | 1848814531495591936 |
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| author | Woon, Luke Sy-Cherng Nazirah A, Mohd Muhaimin MH, Hatta Sidi, Wan Asyraf Wan Zaidi, |
| author_facet | Woon, Luke Sy-Cherng Nazirah A, Mohd Muhaimin MH, Hatta Sidi, Wan Asyraf Wan Zaidi, |
| author_sort | Woon, Luke Sy-Cherng |
| building | UKM Institutional Repository |
| collection | Online Access |
| description | Neuroleptic malignant syndrome (NMS) is a well-known and potentially fatal
complication of antipsychotic use. The elderly population, with multiple risk
factors, are more vulnerable to this condition. We described a case of an 80-year-old man with bipolar disorder, previously on oral extended-release sodium
valproate, aripiprazole and long-acting injectable paliperidone, who developed
NMS. He presented with generalised muscle rigidity, fever, fluctuating blood
pressure and elevated creatinine kinase during his hospitalisation for a manic
episode. Contributing factors included old age, underlying vascular Parkinsonism,
electrolyte imbalance, intercurrent lung infection with acute exacerbation of chronic
obstructive pulmonary disease, hyperactive delirium, and repeated administration
of parenteral typical antipsychotic. Antipsychotics were withheld promptly, and the
patient was treated with dantrolene, bromocriptine and amantadine. His symptoms
resolved after a week. He subsequently remained well with oral extended-release
sodium valproate alone. Relevant clinical points are discussed. Clinical vigilance,
close interdisciplinary cooperation, and prompt interventions are keys to successful
to management of NMS in elderly patients. |
| first_indexed | 2025-11-15T00:35:34Z |
| format | Article |
| id | oai:generic.eprints.org:18284 |
| institution | Universiti Kebangasaan Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T00:35:34Z |
| publishDate | 2021 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | oai:generic.eprints.org:182842022-03-25T01:57:38Z http://journalarticle.ukm.my/18284/ Neuroleptic malignant syndrome in an elderly patient with bipolar disorder Woon, Luke Sy-Cherng Nazirah A, Mohd Muhaimin MH, Hatta Sidi, Wan Asyraf Wan Zaidi, Neuroleptic malignant syndrome (NMS) is a well-known and potentially fatal complication of antipsychotic use. The elderly population, with multiple risk factors, are more vulnerable to this condition. We described a case of an 80-year-old man with bipolar disorder, previously on oral extended-release sodium valproate, aripiprazole and long-acting injectable paliperidone, who developed NMS. He presented with generalised muscle rigidity, fever, fluctuating blood pressure and elevated creatinine kinase during his hospitalisation for a manic episode. Contributing factors included old age, underlying vascular Parkinsonism, electrolyte imbalance, intercurrent lung infection with acute exacerbation of chronic obstructive pulmonary disease, hyperactive delirium, and repeated administration of parenteral typical antipsychotic. Antipsychotics were withheld promptly, and the patient was treated with dantrolene, bromocriptine and amantadine. His symptoms resolved after a week. He subsequently remained well with oral extended-release sodium valproate alone. Relevant clinical points are discussed. Clinical vigilance, close interdisciplinary cooperation, and prompt interventions are keys to successful to management of NMS in elderly patients. Pusat Perubatan Universiti Kebangsaan Malaysia 2021-12 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/18284/1/22_ms0411_pdf_84231.pdf Woon, Luke Sy-Cherng and Nazirah A, and Mohd Muhaimin MH, and Hatta Sidi, and Wan Asyraf Wan Zaidi, (2021) Neuroleptic malignant syndrome in an elderly patient with bipolar disorder. Medicine & Health, 16 (2). pp. 274-279. ISSN 2289-5728 https://medicineandhealthukm.com/toc/16/2 |
| spellingShingle | Woon, Luke Sy-Cherng Nazirah A, Mohd Muhaimin MH, Hatta Sidi, Wan Asyraf Wan Zaidi, Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title | Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title_full | Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title_fullStr | Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title_full_unstemmed | Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title_short | Neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| title_sort | neuroleptic malignant syndrome in an elderly patient with bipolar disorder |
| url | http://journalarticle.ukm.my/18284/ http://journalarticle.ukm.my/18284/ http://journalarticle.ukm.my/18284/1/22_ms0411_pdf_84231.pdf |