Neuroleptic malignant syndrome induced by lamotrigine

Clin Neuropharmacol. 2013 Jul-Aug;36(4):131-2. doi: 10.1097/WNF.0b013e318294799a.

Abstract

This case report describes a 54-year-old man with bipolar I disorder who was treated with aripiprazole (ARP) and lithium. The patient was admitted to our hospital because of aggravation of depressive symptoms, and treatment with lamotrigine (LTG) was initiated. Two weeks after admission, we discontinued administration of ARP after the appearance of a tremor. Three weeks after discontinuing ARP, the patient developed a high fever, rigidity of the arms, diarrhea, dysphagia, and diaphoresis. We suspected these symptoms were consistent with neuroleptic malignant syndrome and therefore removed the application of LTG. After 2 days, most of the patient's symptoms and blood results had improved, leading us to conclude that the LTG treatment had induced neuroleptic malignant syndrome. Thus, the purpose of this case report was to warn psychiatrists against therapy with LTG, as it may be conducive to neuroleptic malignant syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Aripiprazole
  • Bipolar Disorder / drug therapy
  • Drug Monitoring
  • Drug Therapy, Combination / adverse effects
  • Excitatory Amino Acid Antagonists / adverse effects*
  • Excitatory Amino Acid Antagonists / therapeutic use
  • Humans
  • Lamotrigine
  • Lithium / therapeutic use
  • Male
  • Middle Aged
  • Neuroleptic Malignant Syndrome / prevention & control*
  • Piperazines / therapeutic use
  • Quinolones / therapeutic use
  • Sodium Channel Blockers / adverse effects*
  • Sodium Channel Blockers / therapeutic use
  • Treatment Outcome
  • Triazines / adverse effects*
  • Triazines / therapeutic use

Substances

  • Antipsychotic Agents
  • Excitatory Amino Acid Antagonists
  • Piperazines
  • Quinolones
  • Sodium Channel Blockers
  • Triazines
  • Aripiprazole
  • Lithium
  • Lamotrigine