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Osman AHM, Wilkinson J. Aripiprazole-induced quasi-neuroleptic malignant syndrome: two case reports. J Med Case Rep 2024; 18:190. [PMID: 38632633 PMCID: PMC11025188 DOI: 10.1186/s13256-024-04508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Significant elevation of creatine kinase levels (above three digits) and leucocytosis in the absence of muscle rigidity, tremors, or autonomic dysfunction can pose a real challenge in the context of antipsychotic treatment as an early herald of neuroleptic malignant syndrome. CASE PRESENTATION We present here two cases of adult male patients of Black British heritage, ages 51 years and 28 years, respectively. Both received a diagnosis of schizoaffective disorder and presented with massive increase of creatine kinase blood level after aripiprazole depot administration, one with pernicious increase associated with silent neuroleptic malignant syndrome, and the second with asymptomatic benign enzyme elevation. CONCLUSION Though aripiprazole use is less likely to cause neuroleptic malignant syndrome, on rare occasions it can produce massive symptomatic or asymptomatic increase in serum creatine kinase enzyme levels, raising the need for close monitoring, especially at the initial doses of the drug.
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Béchard L, Corbeil O, Thivierge MA, Assaad I, Boulanger C, Mailhot MP, Turgeon-Fournier A, Roy MA, Demers MF. Management of Rhabdomyolysis in a Patient Treated with Clozapine: A Case Report and Clinical Recommendations. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:194-198. [PMID: 35078963 PMCID: PMC8813308 DOI: 10.9758/cpn.2022.20.1.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/08/2021] [Accepted: 06/14/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Laurent Béchard
- Faculty of Pharmacy, Laval University, QC, Canada
- Notre-Dame des Victoires Clinic, University Institute in Mental Health of Quebec, Integrated University Health and Social Services Centres, Capitale-Nationale, QC, Canada
- CERVO Research Center, QC, Canada
| | - Olivier Corbeil
- Faculty of Pharmacy, Laval University, QC, Canada
- Notre-Dame des Victoires Clinic, University Institute in Mental Health of Quebec, Integrated University Health and Social Services Centres, Capitale-Nationale, QC, Canada
- CERVO Research Center, QC, Canada
| | | | | | | | - Marie-Pierre Mailhot
- Notre-Dame des Victoires Clinic, University Institute in Mental Health of Quebec, Integrated University Health and Social Services Centres, Capitale-Nationale, QC, Canada
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, QC, Canada
| | - Alexis Turgeon-Fournier
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Laval University, QC, Canada
- Department of Anesthesiology & Department of Medicine, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), CHU de Québec-Université Laval Research Center, Quebec City, QC, Canada
| | - Marc-André Roy
- Notre-Dame des Victoires Clinic, University Institute in Mental Health of Quebec, Integrated University Health and Social Services Centres, Capitale-Nationale, QC, Canada
- CERVO Research Center, QC, Canada
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, QC, Canada
| | - Marie-France Demers
- Faculty of Pharmacy, Laval University, QC, Canada
- Notre-Dame des Victoires Clinic, University Institute in Mental Health of Quebec, Integrated University Health and Social Services Centres, Capitale-Nationale, QC, Canada
- CERVO Research Center, QC, Canada
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