A Case of Atypical Neuraoleptic Malignant Syndrome following Clozapine Treatment

Neuroleptic Malignant Syndrome (NMS) is an adverse effect of antipsychotic medication. Here, we described an atypical NMS case following treatment with clozapine, without the main clinical features (fever and rigidity) of NMS.
Case report: This report described a rare case of NMS in a 49- year old male with schizophrenia, under treatment with 500mg/day clozapine since 5 months ago, and admitted for evaluation of altered mental status. Additional clinical findings included severe diaphoresis, fluctuating blood pressure and tachycardia. After diagnosis of NMS, treatment with supportive and pharmaco-therapeutic measures were immediately initiated, resulting in complete resolution of symptoms. He was discharged with 30mg aripiprazole daily and presents no side effects in 4 years of follow up. Although NMS can be easily recognized in typical presentation, but it could be consist of different types of onset, clinical findings and course, and also it can present a benign prognosis if recognized and treated early.