PAROXETIN-INDUCED MALIGNANT NEUROLEPTIC SYNDROME

We report on a ZZ-year-old schizophrenic patient who attempted suicide and suffered an epidural hemorrhage. 16 days after the neurosurgical operation. After several weeks of treatment with promethazine, 1 day a fter intake of paroxetin he partially lost consciousness and developed extra pyramidal symptoms and vegetative disorders. Hyper-Ck-aemia up to 680 U/l was observed. Malignant neuroleptic syndrome (MNS) was diag nosed, which led to withdrawal of paroxetin and promethazine. He was p ut on dantamacrine and amantadine until the symptoms resolved. To date there have been few reports on MNS under tricyclic antidepressants an d selective serotonin inhibitors. The influence of the central seroton ergic system on the pathophysiology of MNS is discussed.