SEVERE HYPERTHERMIA DURING TETRABENAZINE THERAPY FOR TARDIVE-DYSKINESIA

We recently observed a 45-year-old patient with a history of psychiatr ic illness who presented with severe hyperthermia (rectal temperature above 41 degrees C) with intense rhabdomyolysis and liver cytolysis du ring tetrabenazine therapy for neuroleptic tardive dyskinesia. In addi tion to tetrabenazine, this patient took lorazepam and two antidepress ant drugs. clomipramine, a potent serotonin-reuptake inhibitor, and mi anserin. Hyperthermia responded to parenteral sodium dantrolene and or al bromocriptine administration. The significant role of tetrabenazine (a central nervous system dopamine-depleting drug) and the contributi on of antidepressants to the mechanism of this neuroleptic malignant s yndrome-like hyperthermia are discussed.