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Lethal Catatonia and Neuroleptic Malignant Syndrome

A Dopamine Receptor Shut-down Hypothesis

Published online by Cambridge University Press:  02 January 2018

Abdelkarim A. Osman  and
Mohamed H. Khurasani
Abdelkarim A. Osman*
Affiliation:
King Fahd Hospital, Jeddah, Saudi Arabia
Mohamed H. Khurasani
Affiliation:
King Fahd Hospital, Jeddah, Saudi Arabia
*
Dr Osman, PO Box 50505 (176), King Fahd Hospital, Jeddah, Saudi Arabia
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Abstract

Background

Lethal catatonia and neuroleptic malignant syndrome (NMS) have been suggested to have a common neurochemical cause. We hypothesise that both conditions may be due to a sudden and massive blockade of dopamine neurotransmitters.

Method

NMS was diagnosed in psychotic in-patients treated with neuroleptics if four features were present: diffuse severe rigidity, altered level of consciousness, hyperpyrexia and autonomic instability.

Results

Over three years, five NMS cases were diagnosed. Two presented with catatonic features and were diagnosed as acute reactive psychosis. Their neuroleptic doses were small, arguing for a particular sensitivity in these two cases.

Conclusion

The sensitivity of two patients with catatonic features who developed NMS with small doses of neuroleptics supports a common neurochemical basis for the two conditions.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 4 , October 1994 , pp. 548 - 550
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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