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NMS induced by SSSRIs appears to be extremely rare.
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Combination treatment with risperidone and fluvoxamine is reported to cause neurotoxic syndrome in one patient. NMS is also reported when SSRI like fluvoxamine is combined with a second-generation antipsychotic like quetiapine. NMS has been reported in patients treated with SSRIs such as fluoxetine and citalopram. There are very few reports of NMS occurring in patients exposed to SSRI. This has led to the change in the understanding of pathogenesis of NMS. Although NMS was classically described occurring with use of “Typical” antipsychotic drugs or neuroleptics, recent studies show its association with use of “Atypical” antipsychotics and selective serotonin reuptake inhibitors (SSRIs). Death in NMS may occur due to complications involving renal, cardiovascular systems, and respiratory insufficiency. Hypernatremia, hyperkalemia, and metabolic acidosis can occur in complicated cases. Other features which aid in diagnosing NMS include laboratory parameters such as raised creatine phosphokinase (CPK) levels, leukocytosis, and myoglobinuria. The characteristic clinical features of NMS include extrapyramidal signs such as rigidity autonomic signs such as hyperthermia, fluctuating blood pressure, tachycardia, and tachypnea and mental status changes such as confusion. The estimated incidence of NMS is about 0.2%, and mortality rates range between 4% and 30%. Neuroleptic malignant syndrome (NMS) is an uncommon but life-threatening, idiosyncratic drug reaction that occurs following neuroleptic drug exposure. Fluvoxamine-induced neuroleptic malignant syndrome.
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How to cite this URL: Bellad A, Koparde V, Patil S, Chate S. How to cite this article: Bellad A, Koparde V, Patil S, Chate S. Keywords: Adverse drug reactions, fluvoxamine, neuroleptic malignant syndrome, SSRIs Here, we report a rare case of NMS induced by fluvoxamine. NMS occurring with selective serotonin reuptake inhibitors' use is extremely rare, and it should be differentiated from serotonin syndrome. There is increasing evidence that “Atypical” antipsychotics are associated with NMS that has a different character. The estimated incidence of NMS is though very low, resulting mortality rates range between 4% and 30%.
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Neuroleptic malignant syndrome (NMS) is an uncommon but life-threatening idiosyncratic drug reaction that occurs following neuroleptic drug exposure.