Clozapine Rechallenge Following Neuroleptic Malignant Syndrome: A Systematic Review.

  title={Clozapine Rechallenge Following Neuroleptic Malignant Syndrome: A Systematic Review.},
  author={J. Lally and Cathal McCaffrey and Conall OʼMurchu and A. Krivoy and A. Gu{\'e}randel and J. MacCabe and F. Gaughran},
  journal={Journal of Clinical Psychopharmacology},
PURPOSE/BACKGROUND Neuroleptic malignant syndrome (NMS) has been described with most antipsychotics, most commonly first generation. Clozapine has also been associated with NMS. METHODS/PROCEDURES We conducted a systematic review to identify all studies investigating or describing (a) clozapine rechallenge following suspected NMS associated with clozapine, (b) clozapine use after suspected NMS associated with another antipsychotic, and (c) rechallenge with nonclozapine antipsychotics after… Expand
3 Citations
Clozapine in the treatment of refractory schizophrenia: a practical guide for healthcare professionals
There is a need for better management of serious clozapine-related adverse events in addition to agranulocytosis, and better education of patients and carers, general practitioners, A&E and ITU staff and others of the problems posed in using clozAPine safely. Expand
Neuroleptic malignant syndrome: a guide for psychiatrists
Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal adverse reaction to drugs. In psychiatric practice, it is mainly associated with antipsychotics. The classic presentation isExpand
Clozapine Combination and Augmentation Strategies in Patients With Schizophrenia -Recommendations From an International Expert Survey Among the Treatment Response and Resistance in Psychosis (TRRIP) Working Group.
Given the limited evidence from randomized trials of treatment strategies for clozapine-resistant schizophrenia (CRS), this consensus-based series of recommendations provides a framework for decision making to manage this challenging clinical situation. Expand


Neuroleptic Rechallenge after Neuroleptic Malignant Syndrome: Case Report and Literature Review
The results of the review suggest that neuroleptic rechallenge following NMS is associated with an acceptable risk of recurrence in most patients, however, close monitoring for NMS and careful selection of patients for antipsychotic rechallenges is mandatory. Expand
Neuroleptic Malignant Syndrome Associated with Atypical Antipsychotic Drugs
It is suggested that, in general, NMS associated with atypical antipsychotic drugs manifests in a typical manner, and one notable exception is clozapine-induced NMS, which appears less likely to manifest with extra-pyramidal features, including rigidity and tremor. Expand
Neuroleptic malignant syndrome and clozapine.
  • S. Reddig, A. Minnema, R. Tandon
  • Medicine
  • Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 1993
NMS should be included in the differential diagnosis of a febrile patient with a history of any neuroleptic treatment, including clozapine, as a single agent that developed in a patient with no prior history of NMS. Expand
Clozapine-induced neuroleptic malignant syndrome: review and report of new cases.
It is suggested that typical NMS does occur with clozapine and that its incidence may be as common as with the classic neuroleptics and with fewer extrapyramidal side effects and a lower rise in creatine kinase levels. Expand
Neuroleptic malignant syndrome induced by atypical antipsychotics
  • D. Farver
  • Medicine
  • Expert opinion on drug safety
  • 2003
By evaluating the case reports of atypical antipsychotic-induced NMS, valuable information may be obtained concerning similarities or differences from that induced by the traditional antipsychotics. Expand
Second-Generation Antipsychotics and Neuroleptic Malignant Syndrome: Systematic Review and Case Report Analysis
Systematic analysis of case reports suggests that even the most recently marketed antipsychotics are not free from the risk of inducing NMS, and primary studies suggest that SGA-NMS is characterized by lower incidence, lower clinical severity, and less frequent lethal outcome. Expand
[Neuroleptic malignant syndrome after 30 years treatment with clozapine: a rarely seen differential diagnosis on intensive care units].
The differential diagnosis of NMS is not always trivial and is therefore discussed and the therapy with clozapine was stopped definitively and benzodiazepines were administered assuming a relapse of an alleviated, probably reconvening NMS. Expand
Apparent neuroleptic malignant syndrome with clozapine and lithium.
When clozapine was administered (in conjunction with lithium) to a patient with a past history of NMS with fluphenazine, the syndrome reappeared after about 3 weeks of treatment, the first report of apparent neuroleptic malignant syndrome with clozAPine. Expand
Neuroleptic malignant syndrome due to atypical neuroleptics: three episodes in one patient.
Three episodes of NMS are described that fulfilled the DSM-IV criteria for NMS (APA, 1994) and had some atypical features that will be discussed with regard to the pathophysiological mechanisms leading to NMS. Expand
Neuroleptic Malignant Syndrome and Clozapine Monotherapy
Neuroleptic malignant syndrome can occur at any stage of clozapine treatment, and the patient can be rechallenged after such an episode. Expand