Neuroleptic malignant syndrome-like reaction precipitated by antipsychotics in a patient with gamma-butyrolactone withdrawal

J Addict Med. 2011 Dec;5(4):302-3. doi: 10.1097/ADM.0b013e3182236730.

Abstract

We report the case of a patient with chronic abuse of gamma-butyrolactone (GBL, 3 bottles per week for 4 months), who in the course of the management of acute agitation and hallucinations developed symptoms compatible with both neuroleptic malignant syndrome and GBL withdrawal symptoms.Some GHB withdrawal symptoms are similar to those of neuroleptic malignant syndrome, and the administration of antipsychotics might worsen the neurological condition of patients. So, it seems important to rapidly detect drugs taken by patients with mental agitation, to optimize management and minimize complications related to drugs.

Publication types

  • Case Reports

MeSH terms

  • 4-Butyrolactone / toxicity*
  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Clonazepam / administration & dosage
  • Clonazepam / adverse effects
  • Diagnosis, Differential
  • Drug Evaluation, Preclinical
  • Drug Therapy, Combination
  • Female
  • Hallucinations / chemically induced*
  • Hallucinations / drug therapy*
  • Humans
  • Infusions, Intravenous
  • Injections, Intramuscular
  • Loxapine / administration & dosage
  • Loxapine / adverse effects
  • Neuroleptic Malignant Syndrome / diagnosis*
  • Psychomotor Agitation / drug therapy
  • Psychomotor Agitation / etiology*
  • Solvents / toxicity*
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / etiology*
  • Substance-Related Disorders / rehabilitation*

Substances

  • Antipsychotic Agents
  • Solvents
  • Clonazepam
  • Loxapine
  • 4-Butyrolactone