Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-20T08:26:50.977Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuroleptic malignant syndrome in cancer treatment

Published online by Cambridge University Press:  24 August 2005

CHIAKI KAWANISHI ,
HIDEKI ONISHI ,
DAIJI KATO ,
TOMOKI YAMADA ,
MASANARI ONOSE  and
YOSHIO HIRAYASU
CHIAKI KAWANISHI
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
HIDEKI ONISHI
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan Department of Psychiatry, Kanagawa Prefecture Cancer Center, Asahi-ku, Yokohama, Japan
DAIJI KATO
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
TOMOKI YAMADA
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
MASANARI ONOSE
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
YOSHIO HIRAYASU
Affiliation:
Department of Psychiatry, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to neuroleptics. Several prospective studies have reported NMS occurrence rates ranging from 0.07% to 2.2% of patients receiving neuroleptics. However, few occurrences of NMS have been reported in cancer patients despite frequent complications of cancer and its treatment by mental disorders managed with neuroleptic drugs. Exhaustion, dehydration, and malnutrition are considered risk factors for NMS, and cancer patients represent a high risk group for NMS.

Methods: We describe a patient with metastatic chondrosarcoma who had received frequent neuroleptic injections prior to brain surgery and developed NMS in the intensive care unit immediately after surgery. The patient showed delirium, hyperpyrexia, tachycardia, diaphoresis, and extrapyramidal symptoms. After a diagnosis of NMS was made, supportive care and careful monitoring were carried out, and the patient recovered over an interval of 11 days.

Results and significance of the research: Clinical NMS studies have been conducted mainly in psychiatric units, but NMS can occur wherever psychotropic drugs are administered. NMS can be difficult to diagnose due to multiple complicating factors in cancer treatment, but the diagnosis is highly important given the risk of death. Recognition of prodromal NMS symptoms can facilitate actions to decrease morbidity and mortality. It is suggested that special attention to cancer patients undergoing psychopharmacologic treatment is required in clinical oncologic practice.

Keywords

Adverse drug reactionCancerNeurolepticsNeuroleptic malignant syndrome
Type
CASE REPORT
Information
Palliative & Supportive Care , Volume 3 , Issue 1 , March 2005 , pp. 51 - 53
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bakri, Y.N., Khan, R., Subhi, J., et al. (1992). Case report: Neuroleptic malignant syndrome associated with metoclopramide antiemeric therapy. Gynecologic Oncology, 44, 189–190.Google Scholar
Kawanishi, C. (2003). Genetic predisposition to neuroleptic malignant syndrome: Implication for antipsychotic therapy. American Journal of Pharmacogenomics, 3, 89–95.Google Scholar
Kishida, I., Kawanishi, C., Furuno, T., et al. (2004). Association in Japanese patients between neuroleptic malignant syndrome and functional polymorphisms of the dopamine D2 receptor gene. Molecular Psychiatry, 9, 293–298.Google Scholar
Onose, M., Kawanishi, C., Onishi, H., et al. (2002). Neuroleptic malignant syndrome following bone marrow transplantation. Bone Marrow Transplantation, 29, 803–804.Google Scholar
Pope, G.H., Keck, P.E., & McElroy, S.L. (1986). Frequency and presentation of neuroleptic malignant syndrome in a large psychiatric hospital. The American Journal of Psychiatry, 143, 1227–1233.Google Scholar
Russell, C.S., Lang, C., McCambridge, M., et al. (2001). Neuroleptic malignant syndrome in pregnancy. Obstetrics & Gynecology, 98, 906–908.Google Scholar
Shalev, A. & Munitz, H. (1986). The neuroleptic malignant syndrome: Agent and host interaction. Acta Psychiatrica Scandinavica, 73, 337–347.Google Scholar
Tanaka, K., Akechi, T., Yamazaki, M., et al. (1998). Neuroleptic malignant syndrome during haloperidol treatment in a cancer patient: A case report. Supportive Care in Cancer, 6, 536–538.Google Scholar
Tenenbein, M. (1985). The neuroleptic malignant syndrome: Occurrence in a 15-year-old boy and recovery with bromocriptine therapy. Pediatric Neuroscience, 12, 161–164.Google Scholar
Zohar, Y., Talmi, Y.P., Sabo, R., et al. (1992). Neuroleptic malignant syndrome during perphenazine treatment in a patient with head and neck cancer: A case report. Otolaryngology-Head and Neck Surgery, 106, 206–208.Google Scholar