Reactions 1031 - 11 Dec 2004

SClomipramine

Neuroleptic malignant syndrome: case reportA 57-year-old man with frontal lobe dementia developed

neuroleptic malignant syndrome during treatment withclomipramine.

The man presented with a fever, sweating, muscle rigidity,urinary incontinence and decreased responsivenessapproximately 2 years after starting treatment withclomipramine [dosage not stated] and promazine. Empiricalantibacterial treatment was started for a presumed urinarytract infection. His symptoms improved, but recurredapproximately 4 months later, and he was again treated withantibacterials for a presumed urinary tract infection;promazine was also discontinued at this time. His symptomsimproved but, later that same month, he developed fever,sweating, muscle rigidity and decreased responsiveness; anadverse drug reaction was suspected.

Clomipramine and ciprofloxacin were discontinued and,within 48 hours, the man’s symptoms had resolved. Asubsequent rechallenge with clomipramine resulted in rapidrecurrence of his symptoms after 3 doses, with resolution ondiscontinuation of the agent.Haddow AM, et al. Clomipramine induced neuroleptic malignant syndrome andpyrexia of unknown origin. BMJ 329: 1333-1335, No. 7478, 4 Dec 2004 -Scotland 800967576

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Reactions 11 Dec 2004 No. 10310114-9954/10/1031-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved