A patient suffering from a rare enzyme deficiency developed a malignant neuroleptic syndrome after having been treated with one single dose of haloperidol. We investigated the patient's serum for all frequent polymorphisms in cytochrome P450 2D6, assuming him to be a poor neuroleptic metabolizer. We will also discuss other potential mechanisms inducing this disturbance and its differential diagnoses.
References
-
1 Aicardi J. Diseases of the Nervous System in Childhood. 2nd edition. Cambridge; Mac Keith Press, University Press 1998
-
2
Boyd R D.
Neuroleptic malignant syndrome and mental retardation: review and analysis of 29 cases.
Am J Ment Retardation.
1993;
98
(3)
359
-
3
Denborough M.
Malignant hyperthermia.
Lancet.
1998;
352
1131-1136
-
4
Fink M.
Neuroleptic Malignant Syndrome and Catatonia: One Entity or Two?.
Biol Psychiatry.
1996;
39
1-4
-
5
Fink M.
Toxic Serotonin Syndrome or Neuroleptic Malignant Syndrome?.
Pharmacopsychiat.
1996;
29
159-161
-
6
Gibson K M, Christensen E, Jakobs C.
The clinical phenotype of succinic semialdehyde dehydrogenase deficiency aciduria: case reports of 23 new patients.
Pediatrics.
1997;
99
567-574
-
7
Gibson K M, Hoffmann G F, Hodson A K, Boiglieri T, Jakobs C.
4-Hydroxybutyric acid and the clinical phenotype of succinic semialdehyde dehydrogenase deficiency, an inborn error of GABA metabolism.
Neuropediatrics.
1998;
29
(1)
14-22
-
8
Guerra R J.
Sympathoadrenal Hyperactivity and the Etiology of Neuroleptic Malignant Syndrome.
Am J Psychiatry.
1999;
156
169-180
-
9 Hardman J G, Limbird L E, Molinoff P B, Ruddon R W, Gilnian A G. The Pharmacological basic of therapeutics. 9th edition. New York; MacGraw-Hill 1995: 1143
-
10 Leonhard K. The Classification of Endogenous Psychoses, 5th ed. New York; Irvington 1979
-
11
Levenson J L.
Neuroleptic malignant syndrome.
Am J Psychiatry.
1985;
142
1137-1145
-
12
Mihara K, Suzuki A, Konto T, Yasui N, Furukori H, Nagashima U, Otani K, Kaneko S, Inoue Y.
Effects of the CYP2D6*10 allele on the steady-state plasma concentrations of haloperidol in Japanese patients with schizophrenia.
Clin Pharmacol Ther.
1999;
65
(3)
291-294
-
13
Nisijima K, Ishiguro T.
Cerebrospinal fluid levels of monoamine metabolites and gamma-aminobutyric acid in neuroleptic malignant syndrome.
J Psychiat Res.
1995;
5/6
233-244
-
14
Sachse C, Brockmöller J, Bauer S, Roots I.
Cytochrome P450 2D6 Variants in a Caucasian Population: Allele Frequencies and Phenotypic Consequences.
Am J Hum Genet.
1997;
60
284-295
-
15
Spina E, Ancione M, Di Rosa A E, Meduri M, Caputi A P.
Polymorphic debrisoquine oxidation and acute neuroleptic-induced adverse effects.
Eur J Clin Pharmacol.
1992;
42
(3)
347-348
Dr. Peter Neu
Psychiatrische Poliklinik der FU Berlin
Eschenallee 3
14050 Berlin
Germany
Phone: + 49-30-8445-8673
Fax: + 49-30-8445-8388
Email: peter.neu@medizin.fu-berlin.de