NEUROLEPTIC MALIGNANT SYNDROME-ASSOCIATED WITH OLANZAPINE

OBJECTIVE: To report a case of neuroleptic malignant syndrome (NMS) as sociated with the use of olanzapine, case CASE SUMMARY: A 67-year-old white man with bipolar disorder developed nausea and vomiting. After 1 2 days, he became confused, delirious, and manic. His only medications were olanzapine 10 mg/d and divalproex sodium 500 mg bid. He was admi tted to a hospital and treated for dehydration and mania. Olanzapine w as given on 6 of the first 7 hospital days. On hospital day 6, typical NMS developed with the body temperature increasing to 39.9 degrees C, obtundation, rigidity, tremor,diaphoresis, fluctuating pupillary diam eter, labile tachycardia and hypertension, hypernatremia, and elevated serum creatine kinase. Olanzapine was stopped after hospital day 7, a nd the syndrome resolved by hospital day 12.DISCUSSION: The patient ha d all of the major manifestations of NMS. There was no other likely ex planation for his illness and he received no other drug Likely to be a ssociated with the syndrome. This is the first case reported in which NMS was associated with olanzapine.