丹曲林钠治疗氨磺必利相关恶性综合征1例

Dantrolene sodium treatment of amisulpride-related neuroleptic malignant syndrome:a case report

1例32岁女性精神分裂症患者,长期使用氯氮平治疗,抗精神病药更换为氨磺必利后次日出现浅昏迷、持续高热和肌张力高等症状,结合患者肌酸磷酸激酶增高及其他检查结果,诊断为氨磺必利相关恶性综合征。立即停用氨磺必利,给予溴隐亭治疗后无改善。静脉注射丹曲林钠后,当日患者体温开始下降,抽搐与震颤好转,其余症状也逐步缓解,5 d后意识好转,10 d后出院。氨磺必利相关恶性综合征较为罕见,在常规治疗无效时,可使用丹曲林钠治疗。

A 32-year-old woman,previously diagnosed with schizophrenia and undergoing long-term treatment with clozapine,experienced the onset of symptoms such as shallow coma,persistent high fever,and increased muscle tone one day after transitioning from clozapine to amisulpride.Combining with elevated creatine kinase levels and other examination findings,the patient was diagnosed with amisulpride-related neuroleptic malignant syndrome(NMS).Amisulpride treatment was promptly discontinued,and the patient was treated with bromocriptine,but it failed to relieve the symptoms.On the same day,intravenous administration of dantrolene sodium was conducted,then her body temperature decreased,convulsions and tremors improved,and other symptoms gradually relieved.After 5 days,her consciousness improved,and she was discharged after 10 days.Amisulpride-related NMS are relatively rare,and dantrolene sodium can be used as a potential option when conventional treatments prove ineffective.