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Hyperthermia syndromes in psychiatry

  • Niraj Ahuja and Andrew J. Cole

Summary

Presence of fever in psychiatric patients may signify a number of potentially fatal conditions. Several of these are related to treatments (e.g. neuroleptic malignant syndrome with antipsychotics, serotonin syndrome with serotonergic antidepressants, and malignant hyperpyrexia with anaesthesia used for administration of electroconvulsive therapy) or exacerbated by them (e.g. malignant catatonia with antipsychotics). New classes of drug treatment may be changing the epidemiology of these disorders. We suggest that an initial diagnosis of hyperthermia syndrome is clinically useful as there are some important commonalities in treatment. We outline a systematic approach to identify a particular subtype of hyperthermia syndrome and the indications for more specific treatments where available.

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Copyright

Corresponding author

Dr Niraj Ahuja, Wallsend Community Mental Health Team, Sir G.B. Hunter Memorial Hospital, The Green, Wallsend NE28 7PD. Email: niraj.ahuja@ncl.ac.uk

Footnotes

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Declaration of Interest

N.A. has received honoraria for lectures/travel grants from AstraZeneca, Boehringer Ingelheim, Bristol-Meyers Squibb, Eli Lilly, Janssen-Cilag, and Wyeth.

Footnotes

References

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Abbott, RJ, Loizou, LA (1986) Neuroleptic malignant syndrome. British Journal of Psychiatry; 148: 4751.
Abrams, R, Taylor, MA (1976) Catatonia. A prospective clinical study. Archives of General Psychiatry; 33: 579–81.
Adityanjee, Singh S, Singh, G et al (1988) Spectrum concept of neuroleptic malignant syndrome. British Journal of Psychiatry; 153: 107–11.
Adityanjee (1991) The myth of elevated serum creatine phosphokinase level and neuroleptic malignant syndrome. British Journal of Psychiatry; 158: 706–7.
Adityanjee, Mathews T, Aderibigbe, YA (1999) Proposed research diagnostic criteria for neuroleptic malignant syndrome. International Journal of Neuropsychopharmacology; 2: 129–44.
Ahuja, N, Nehru, R (1990) Neuroleptic malignant syndrome: a subtype of lethal catatonia? Acta Psychiatrica Scandinavica; 92: 398.
Ahuja, N (2000) Organic catatonia. Indian Journal of Psychiatry; 42: 327–46.
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revised (DSM–IV–TR). APA.
Ayd, FJ (1956) Fatal hyperpyrexia during chlorpromazine treatment. Journal of Clinical and Experimental Psychopathology and Quarterly Review of Psychiatry and Neurolology; 17: 189–92.
Billig, O, Freeman, WT (1944) Fatal catatonia. American Journal of Psychiatry; 100: 633–8.
Boyer, EW, Shannon, M (2005) The serotonin syndrome. New England Journal of Medicine; 352: 1112–20.
Bush, G, Fink, M, Petrides, G et al (1996) Catatonia. I. Rating scale and standardized examination. Acta Psychiatrica Scandinavica; 93: 129–36.
Caroff, S, Rosenberg, H, Gerber, JC (1983) Neuroleptic malignant syndrome and malignant hyperpyrexia. Lancet; I: 244.
Caroff, SN, Mann, SC (1988) Neuroleptic malignant syndrome. Psychopharmacology Bulletin; 24: 25–9.
Caroff, SN, Mann, SC (1993) Neuroleptic malignant syndrome. Medical Clinics of North America; 77: 185202.
Caroff, SN, Mann, SC, Campbell, EC (2000) Atypical antipsychotics and neuroleptic malignant syndrome. Psychiatric Annals; 30: 314–21.
Caroff, SN, Rosenberg, H, Mann, SC et al (2001) Neuroleptic malignant syndrome in the perioperative setting. American Journal of Anesthesiology; 28: 387–93.
Carroll, BT, Goforth, HW (1995) Serum iron in catatonia. Biological Psychiatry; 38: 776–7.
Chopra, MP, Prakash, SS, Raguram, R (1999) The neuroleptic malignant syndrome: an Indian experience. Comprehensive Psychiatry; 40: 1923.
Delay, J, Pichot, P, Lemperiere, MT et al (1960) Un neuroleptique majaeur non-phenothiazineque et non reserpinique, l'halidol, dans le traitment des psychoses. Annales Médico-Psychologiques; 118.
Delay, J, Deniker, P (1968) Drug induced extrapyramidal syndromes. In Handbook of Clinical Neurology, Volume 6: Diseases of the Basal Ganglia (eds Vinken, PJ, Bruyn, GW) 248–66. North-Holland.
Denborough, MA, Lovell, RRH (1960) Anaesthetic deaths in a family. Lancet; ii: 45.
Deng, MZ, Chen, GQ, Phillips, MR (1990) Neuroleptic malignant syndrome in 12 of 9,792 Chinese inpatients exposed to neuroleptics: a prospective study. American Journal of Psychiatry; 147: 1149–55.
Dharmarajan, TS, Bullecer, MF, Gorich, G (2001) Drug-related hyperthermia. Journal of the American Medical Directors Association; 2: 160–5.
Dunkley, EJC, Isbister, GK, Sibbritt, D et al (2003) Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rule for serotonin toxicity. Quarterly Journal of Medicine; 96: 635–42.
Exton-Smith, AN (1972) Phenothiazines in cold weather. BMJ; 1: 441.
Fink, M, Taylor, MA (2003) Catatonia: A Clinician's Guide to Diagnosis and Treatment. Cambridge University Press.
Gelenberg, AJ (1976) The catatonic syndrome. Lancet; 1: 1339–41.
Gurrera, RJ, Simpson, JC, Tsuang, MT (2007) Meta-analytic evidence of systematic bias in estimates of neuroleptic malignant syndrome incidence. Comprehensive Psychiatry; 48: 205–11.
Hasan, S, Buckley, P (1998) Novel antipsychotics and the neuroleptic malignant syndrome: a review and critique. American Journal of Psychiatry; 155: 1113–6.
Hoagland, RJ, Bishop, RH Jr (1961) A physiologic treatment of heat stroke. American Journal of Medical Sciences; 241: 415–22.
Hynes, AF, Vickar, EL (1996) Case study: neuroleptic malignant syndrome without pyrexia. Journal of American Academy of Child and Adolescent Psychiatry; 35: 959–62.
Insel, TR, Roy, BF, Cohen, RM et al (1982) Possible development of the serotonin syndrome in man. American Journal of Psychiatry; 139: 954–5.
Isbister, GK, Buckley, NA, Whyte, IM (2007) Serotonin: a practical approach to diagnosis and treatment. Medical Journal of Australia; 187: 361–5.
Jauss, M, Krack, P, Franz, M et al (1996) Imaging of dopamine receptors with [123I]Iodobenzamide single-photon emission-computed tomography in neuroleptic malignant syndrome. Movement Disorders; 11: 726–8.
Keck, PE Jr., Pope, HG, McElroy, SL (1991) Declining frequency of neuroleptic malignant syndrome in a hospital population. American Journal of Psychiatry; 148: 880–2.
Kellam, AMP (1987) The neuroleptic malignant syndrome, so-called. A survey of world literature. British Journal of Psychiatry; 150: 752–9.
Khaldarov, V (2000) Benzodiazepines for treatment of neuroleptic malignant syndrome. Hospital Physician; 6: 51–5.
Koch, M, Chandragiri, S, Rizvi, S et al (2000) Catatonic signs in neuroleptic malignant syndrome. Comprehensive Psychiatry; 41: 73–5.
Lazarus, A, Rosenberg, H (1991) Malignant hyperthermia during ECT. American Journal of Psychiatry; 148: 541–2.
Levenson, JL (1985) Neuroleptic malignant syndrome. American Journal of Psychiatry; 142: 1137–45.
Levinson, DF, Simpson, GM (1986) Neuroleptic-induced extrapyramidal symptoms with fever. Heterogeneity of the ‘neuroleptic malignant syndrome’. Archives of General Psychiatry; 43: 839–48.
Mackay, FJ, Dunn, NR, Mann, RD (1999) Antidepressants and the serotonin syndrome in general practice. British Journal of General Practice; 49: 871–4.
Mann, SC, Caroff, SN, Bleier, HR et al (1986) Lethal catatonia. American Journal of Psychiatry; 143: 1374–81.
Mann, SC, Caroff, SN (1987) Neuroleptic malignant syndrome and lethal catatonia. American Journal of Psychiatry; 144: 1370.
Mann, SC, Caroff, SN, Keck, PE et al (2003) Neuroleptic Malignant Syndrome and Related Disorders (2nd edn). American Psychiatric Publishing.
McDaniel, WW (2001) Serotonin syndrome: early management with cyproheptadine. Annals of Pharmacotherapy; 35: 870–3.
McGugan, EA (2001) Hyperpyrexia in the emergency department. Emergency Medicine; 13: 116–20.
Meltzer, HY, Ross-Santon, J, Schelssinger, S (1980) Mean serum creatinine kinase activity in patients with functional psychoses. Archives of General Psychiatry; 37: 650–5.
Mitchell, RS (1955) Fatal toxic encephalitis occurring during iproniazid therapy in pulmonary tuberculosis. Annals of Internal Medicine; 42: 417–24.
Mizuno, Y, Takubo, H, Mizuta, E et al (2003) Malignant syndrome in Parkinson's disease: concept and review of the literature. Parkinsonism and Related Disorders; 9 (suppl 1): S39.
Montoya, A, Ocampo, M, Torres-Ruiz, A (2003) Neuroleptic malignant syndrome in Mexico. Canadian Journal of Clinical Pharmacology; 10: 111–3.
Nehru, R, Ahuja, N (2002) Catatonia following acute dopamine depletion. Journal of Neuropsychiatry and Clinical Neurosciences; 14: 107.
Oates, JA, Sjoerdsma, A (1960) Neurologic effects of tryptophan in patients receiving a monoamine oxidase inhibitor. Neurology; 10: 1076–8.
Osman, AA, Khurasani, MH (1994) Lethal catatonia and neuroleptic malignant syndrome. A dopamine receptor shut-down hypothesis. British Journal of Psychiatry; 165: 548–50.
Otani, K, Horiuchi, M, Kondo, T et al (1991) Is the predisposition to neuroleptic malignant syndrome genetically transmitted? British Journal of Psychiatry; 158: 850–3.
Rajagopal, S (2007) Catatonia. Advances in Psychiatric Treatment; 13: 51–9.
Reulbach, U, Bleich, S (2005) Managing an effective treatment for neuroleptic malignant syndrome. European Neuropsychopharmacology; 15: S518.
Reulbach, U, Dütsch, C, Biermann, T et al (2007) Managing an effective treatment for neuroleptic malignant syndrome. Critical Care; 11: R4, 16.
Rosebush, P, Stewart, T (1989a) A prospective analysis of 24 episodes of neuroleptic malignant syndrome. American Journal of Psychiatry; 146: 717–25.
Rosebush, PI, Stewart, TD, Gelenberg, AJ (1989b) Twenty neuroleptic rechallenges after neuroleptic malignant syndrome in 15 patients. Journal of Clinical Psychiatry; 50: 295–8.
Sachdev, P, Kruk, J, Kneebone, M et al (1995) Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. Journal of Clinical Psychopharmacology; 15: 365–71.
Stauder, KH (1934) Die todliche katatonia [Lethal catatonia]. Archiv fur Psychiatric und Nervenkrankheiten; 102: 614–34 (trans & reprinted in Ungvari GS (ed) (2006) Catatonia: An Anthology of Classical Contributions, pp 104–33. Scientific Communications International).
Sternbach, H (1991) The serotonin syndrome. American Journal of Psychiatry; 148: 705–13.
Troller, JN, Sachdev, PS (1999) Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Australian and New Zealand Journal of Psychiatry; 33: 650–9.
Ueda, M, Hamamoto, M, Nagayama, H et al (2001) Biochemical alterations during medication withdrawal in Parkinson's disease with and without neuroleptic malignant-like syndrome. Journal of Neurology, Neurosurgery and Psychiatry; 71: 111–3.
White, DA (1992) Catatonia and the neuroleptic malignant syndrome – a single entity? British Journal of Psychiatry; 161: 558–60.
Woodbury, MM, Woodbury, MA (1992) Neuroleptic-induced catatonia as a stage in the progression toward neuroleptic malignant syndrome. Journal of American Academy of Child and Adolescent Psychiatry; 31: 1161–4.
Yacoub, A, Francis, A (2006) Neuroleptic malignant syndrome induced by atypical neuroleptics and responsive to lorazepam. Neuropsychiatric Disease and Treatment; 2: 235–40.
Zarrouf, FA, Bhanot, V (2007) Neuroleptic malignant syndrome: don't let your guard down yet. Current Psychiatry; 6: 8995.

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Hyperthermia syndromes in psychiatry

  • Niraj Ahuja and Andrew J. Cole
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