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Common Toxic Syndromes in Psychiatric Practice

Year 2010, Volume: 2 Issue: 4, 532 - 571, 01.12.2010

Abstract

Poisonings and toxic substance exposures are prominent causes of morbidity and mortality in psychiatry. Entoxications which are confronted frequently include clinical scenarios ranging from known drug overdose or drug interactions, as well as, illicit drug use, suicide attempt, or accidental exposure. The clinical evaluation and management of such patients remain challenging. Recognition of major toxic syndromes is important for accurate diagnosis and treatment as well as rapid stabilization of patients and resuscitation. The main focus of this article is to discuss common toxic syndromes (symptom patterns of specific poisoning). These common toxic syndromes include serotonin syndrome, neuroleptic malignant syndrome, anticholinergic, sympathomimetic, opiate, sedative/hypnotic, cholinergic toxic syndromes. All of these syndromes are closely associated with psychiatric signs and symptoms. If recognized early and appropriate treatment is initiated rapidly, majority of patients display favourable outcome.

References

  • Erickson TB, Thompson TM, Lu JJ. The approach to the patient with an unknown overdose. Emerg Med Clin North Am 2007; 25:249-281.
  • Isbister GK, Buckley NA, Whyte IM. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust 2007; 187:361-365..
  • Dvir Y, Smallwood P. Serotonin syndrome: a complex but easily avoidable condition. Gen Hosp Psychiatry 2008; 30:284–287.
  • Attar-Herzberg D, Apel A, Gang N, Dvir D, Mayan H. The serotonin syndrome: initial misdiagnosis. Isr Med Assoc J 2009; 11:367-370.
  • Isbister KG, Bowe JS, Dawson A, Whyte MI. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. Clin Toxicol 2004; 42:277-285.
  • Guo SL, Wu TJ, Liu CC, Ng CC, Chien CC, Sun HL. Meperidine-induced serotonin syndrome in a susceptible patient. Br J Anaesth 2009; 103:369-370.
  • Sansone RA, Sansone LA. Tramadol: seizures, serotonin syndrome, and coadministered antidepressants. Psychiatry (Edgmont) 2009; 6:17-21.
  • Sun-Edelstein C, Tepper SJ, Shapiro RE. Drug-induced serotonin syndrome: a review. Expert Opin Drug Saf 2008; 7:587-596.
  • Gillman PK. CNS toxicity involving methylene blue: the exemplar for understanding and predicting drug interactions that precipitate serotonin toxicity. J Psychopharmacol 2010, doi:10.1177/0269881109359098.
  • Gillman PK. A review of serotonin toxicity data: implications for the mechanisms of antidepressant drug action. Biol Psychiatry 2006; 59:1046-1051.
  • Gillman PK. A systematic review of the serotonergic effects of mirtazapine in humans: implications for its dual action status. Hum Psychopharmacol 2006; 21:117- 125.
  • Isbister GK, Buckley NA. The pathophysiology of serotonin toxicity in animals and humans: Implications for diagnosis and treatment. Clin Neuropharmacol 2005; 28:205-214.
  • Freijo Guerrero J, Tardón Ruiz de Gauna L, Gómez JJ, Aguilera Celorrio L. Serotonin syndrome after administration of mirtazapine in a critical care unit. Rev Esp Anestesiol Reanim 2009; 56:515-516.
  • Gillman PK. Is there sufficient evidence to suggest cyclobenzaprine might be implicated in causing serotonin toxicity? Am J Emerg Med 2009; 27:509-510.
  • Lane R, Baldwin D. Selective serotonin reuptake inhibitor induced serotonin syndrome: review. J Clin Psychopharmacol 1997; 17:208-221.
  • Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003; 96:635-642.
  • Sternbach H. The serotonin syndrome. Am J Psychiatry 1991; 148:705-713.
  • Nisijima K, Yoshino T, Yui K, Katoh S. Potent serotonin (5-HT)(2A) receptor antagonists completely prevent the development of hyperthermia in an animal mo- del of the 5-HT syndrome. Brain Res 2001; 890:23-31.
  • Birmes P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003; 168: 1439-1442.
  • Isbister GK, Downes F, Whyte IM. Olanzapine and serotonin toxicity. Psychiatry Clin Neurosci 2003; 57:244.
  • Odagaki Y. Atypical neuroleptic malignant syndrome or serotonin toxicity associated with atypical antipsychotics? Curr Drug Saf 2009; 4:84-93.
  • Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005; 352:1112-1120.
  • Graudins A, Stearman A, Chan B. Treatment of the serotonin syndrome with cyproheptadine. J Emerg Med 1998; 16:615-619.
  • Graham PM. Successful treatment of the toxic serotonin syndrome with chlorpromazine. Med J Aust 1997; 166:166-167.
  • Boddy R, Dowsett RP, Jeganathan D. Sublingual olanzapine for the treatment of serotonin syndrome. Clin Toxicol 2006; 44:426.
  • Adityanjee, Aderibigbe YA, Matthews T. Epidemiology of neuroleptic malignant syndrome. Clin Neuropharmacol 1999; 22:151-158.
  • Delay J, Deniker P. Drug-induced extra-pyramidal syndromes. In Handbook of Clinical Neurology. Vol. 6: Diseases of the Basal Ganglia (Eds PS Vinken, GW Bruyn): 248–266. North-Holland, New York, Elsevier, 1968.
  • Sarkar P, Natarajan C, Gode N. Prevalence of neuroleptic malignant syndrome in 672 consecutive male in-patients. Indian J Psychiatry 2009; 51:202-205.
  • Haddad PM, Dursun SM. Neurological complications of psychiatric drugs: clinical features and management. Hum Psychopharmacol. 2008; 23(Suppl 1):15-26.
  • Trollor JN, Chen X, Sachdev PS. Neuroleptic malignant syndrome associated with atypical antipsychotic drugs. CNS Drugs 2009; 23:477-492.
  • Caroff SN, Rosenberg H, Mann SC, Campbell EC, Sullivan KA. Neuroleptic malignant syndrome in the critical care unit. Crit Care Med 2002; 30:2609 –2610.
  • Lu TC, Chu PL, Wu CS, Tsai KC, Chen WJ. Neuroleptic malignant syndrome after the use of venlafaxine in a patient with generalized anxiety disorder. J Formos Med Assoc 2006; 105:90-93.
  • Langlow JR, Alarcon RD. Trimipramine-induced neuroleptic malignant syndrome after transient psychogenic polydipsia in one patient. J Clin Psychiatry 1989; 50:144- 145.
  • Gupta S, Racaniello AA. Neuroleptic malignant syndrome associated with amoxapine and lithium in an older adult. Ann Clin Psychiatry 2000; 12:107-109.
  • Tsai HC, Kuo PH, Yang PC. Fever, consciousness disturbance, and muscle rigidity in a 68-year-old man with depressive disorder. Chest 2003; 124:1598-1601.
  • Goldberg RJ. Selective serotonin reuptake inhibitors: infrequent medical adverse effects. Arch Family Med 1998; 7:78–84.
  • Ong KC, Chew EL, Ong YY. Neuroleptic malignant syndrome without neuroleptics. Singapore Med J 2001; 42:85-88.
  • Iwuagwu CU, Riley D, Bonoma RA. Neuroleptic malignant-like syndrome in an elderly patient caused by abrupt withdrawal of tolcapone, a-catechol-o-methyl transferase inhibitor. Am J Med 2000; 108:517-518.
  • Chandran GJ, Mikler JR, Keegan DL. Neuroleptic malignant syndrome: case report and discussion. CMAJ 2003; 169:439-442.
  • Berardi D, Amore M, Keck PE Jr, Troia M, Dell'Atti M. Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: a case-control study. Biol Psychiatry 1998; 44:748-754.
  • Strawn JR, Keck PE, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry 2007; 164:870-876.
  • Isbister GK, Buckley NA. Clomipramine and neuroleptic malignant syndrome: literature on adverse reactions to psychotropic drugs continues to confuse. BMJ 2005; 330:790-791.
  • Margetić B, Margetić BA. Neuroleptic malignant syndrome and its controversies. Pharmacoepidemiol Drug Saf 2010; 19:429-435.
  • Serrano-Duenas M. Neuroleptic malignant syndrome-like, or —dopaminergic malignant syndrome — due to levodopa therapy withdrawal. Clinical features in 11 patients. Parkinsonism Relat Disord 2003; 9:175-178.
  • Kishida I, Kawanishi C, Furuno T, Kato D, Ishigami T, Kosaka K. Association in Japanese patients between neuroleptic malignant syndrome and functional polymorphisms of the dopamine D(2) receptor gene. Mol Psychiatry.2004; 9:293-298.
  • Zivković M, Mihaljević-Peles A, Sagud M, Silić A, Mihanović M. The role of CYP2D6 and TaqI A polymorphisms in malignant neuroleptic syndrome: two case reports with three episodes. Psychiatr Danub 2010; 22:112-116.
  • Pelonero AL, Levenson JL, Pandurangi AK. Neuroleptic malignant syndrome. Psychiatr Serv 1998; 49:1163-1172.
  • Hall RC, Appleby B, Hall RC. Atypical neuroleptic malignant syndrome presenting as fever of unknown origin in the elderly. South Med J 2005; 98:114-117.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision. Washington, DC, American Psychiatric Association, 2000.
  • Pope HG Jr, Cole JO, Choras PT, Fulwiler CE. Apparent neuroleptic malignant syndrome with clozapine and lithium. J Nerv Ment Dis 1986; 174:493-495.
  • Mathews T, Aderibigbe YA. Proposed research diagnostic criteria for neuroleptic malignant syndrome. Int J Neuropsychopharmacol 1999; 2:129-144.
  • Nierenberg D, Disch M, Manheimer E, Patterson J, Ross J, Sivestri G, et al. Facilitating prompt diagnosis and treatment of the neuroleptic malignant syndrome. Clin Pharmacol Ther 1991; 50:580-586.
  • Adityangee, Mathews T, Aderibigbe YA. Proposed research diagnostic criteria for neuroleptic malignant syndrome. Int J Neuropsychopharm 1999; 2:129-144.
  • Farver DK. Neuroleptic malignant syndrome induced by atypical antipsychotics. Expert Opin Drug Saf 2003; 2:21-35.
  • Addonozio G, Susman VL, Roth SD. Neuroleptic malignant syndrome: review and analysis of 115 cases. Biol Psychiatry 1987; 22:1004-1020.
  • Meterissian GB. Risperidone-induced neuroleptic malignant syndrome: a case report and review. Can J Psychiatry 1996; 41:52-54.
  • Sachdev P, Kruk J, Kneebone M, Kissane D. Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. J Clin Psychopharmacol 1995; 15:365
  • Ananth J, Parameswaran S, Gunatilake S, Burgoyne K, Sidhom T. Neuroleptic malignant syndrome and atypical antipsychotic drugs. J Clin Psychiatry 2004; 65:464-470.
  • Seitz DP. Diagnostic uncertainty in a case of neuroleptic malignant syndrome. Can J Emerg Med 2005; 7:266-272.
  • Haddad PM, Dursun SM. Neurological complications of psychiatric drugs: clinical features and management. Hum Psychopharmacol. 2008; 23 (Suppl 1):15-26.
  • Taniguchi N, Tanii H, Nishikawa T. Classification system of complications in neuroleptic malignant syndrome. Methods Find Exp Clin Pharmacol 1997; 19:193- 199.
  • Shalev A, Hermesh H, Munitz H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry 1989; 50:18-25.
  • Labuda A, Cullen N. Brain injury following neuroleptic malignant syndrome: case report and review of the literature. Brain Inj 2006; 20:775-778.
  • Akhaddar A, Karouache A, Elmostarchid B, Boucetta M. Bilateral chronic subdural haematoma misdiagnosed as neuroleptic malignant syndrome. Emerg Med J 2010; 27:233.
  • Birmes P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003; 168:1439-1442.
  • Simon HB. Hyperthermia. N Engl J Med 1993; 329:483-487.
  • Tsutsumi Y, Yamamoto K, Matsuura S, Hata S, Sakai M, Shirakura K. The treatment of neuroleptic malignant syndrome using dantrolene sodium. Psychiatry Clin Neurosci 1998; 52:433-438.
  • Brown TM: Clozapine, neuroleptic malignant syndrome, and pancerebellar syndrome. Psychosomatics 1999; 40:518-520.
  • Storm C, Gebker R, Krüger A, Nibbe L, Schefold JC, Martens F et al. A rare case of neuroleptic malignant syndrome presenting with serious hyperthermia treated with a non-invasive cooling device: a case report. J Med Case Reports 2009; 3:6170.
  • Kaufman KR, Levitt MJ, Schiltz, Sunderram J. Neuroleptic malignant syndrome and serotonin syndrome in the critical care setting: case analysis. Ann Clin Psychiatry. 2006; 18:201-204.
  • Rosenbaum HK, Miller JD. Malignant hyperthermia and myotonic disorders. Anesthesiol Clin North Am 2002; 20:623-664.
  • Ihara M, Kohara N, Urano F, , Ichinose H, Takao S, Nishida T, et al. Neuroleptic malignant syndrome with prolonged catatonia in a dopa-responsive dystonia patient. Neurology 2002; 59:1102-1104.
  • Mannaioni G., Baronti R, Moroni F. Gastrointestinal bleeding and massive liver damage in neuroleptic malignant syndrome. Ther Clin Risk Manag 2005; 1:225-229.
  • Donegan JH, Danegan WL, Cohen EB. Massive hepatic necrosis associated with dantrolene therapy. Digest Dis Sci 1978; 23:48–52.
  • Burns MJ, Linden CH, Graudins A, Brown RM, Fletcher KE. A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning. Ann Emerg Med 2000; 35:374-381.
  • Felder CC. Muscarinic acetylcholine receptors: signal transduction through multiple effectors. FASEB J 1995; 9:619-625.
  • Ishii M, Kurachi Y. Muscarinic acetylcholine receptors. Curr Pharm Des 2006; 12:3573
  • Bolden C, Cusack B, Richelson E. Antagonism by antimuscarinic and neuroleptic compounds at the five cloned human muscarinic cholinergic receptors expressed in Chinese hamster ovary cells. J Pharmacol Exp Ther 1992; 260:576-580.
  • Spina SP, Taddei A. Teenagers with Jimson weed (Datura stramonium) poisoning. CJEM 2007; 9:467-468.
  • Krenzelok EP, Leikin JB. Approach to the poisoned patient. Dis Mon 1996; 42:509- 607.
  • Woolf AD, Erdman AR, Nelson LS, Caravati EM, Cobaugh DJ, Booze LL, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of- hospital management. Clin Toxicol (Phila) 2007; 45:203-233.
  • Pierog JE, Kane KE, Kane BG, Donovan JW, Helmick T. Tricyclic antidepressant toxicity treated with massive sodium bicarbonate. Am J Emerg Med 2009; 27:1168.e3-7.
  • Jones AL, Dargan PI. Churchill’s Textbook of Toxicology. Edinburgh, Churchill- Livingstone, 2001.
  • Harrigan RA and Brady WJ. ECG abnormalities in tricyclic antidepressant ingestion. Am J Emerg Med 1999; 17:387-393.
  • Ozbilen M, Adams CE. Systematic overview of Cochrane reviews for anticholinergic effects of antipsychotic drugs. J Clin Psychopharmacol 2009; 29:141-146.
  • Bolden C, Cusack B, Richelson E. Antagonism by antimuscarinic and neuroleptic compounds at the five cloned human muscarinic cholinergic receptors expressed in Chinese hamster ovary cells. J Pharmacol Exp Ther 1992; 260:576-580.
  • Sharma AN, Hexdall AH, Chang EK, Nelson LS, Hoffman RS. Diphenhydramine- induced wide complex dysrhythmia responds to treatment with sodium bicarbonate. Am J Emerg Med 2003; 21:212-215.
  • Irioka T, Yamanami A, Uchida N, Iwase M, Yasuhara H, Mizusawa H. Opsoclonus caused by diphenhydramine self-poisoning. J Neuroophthalmol 2009; 29:72-73.
  • Jones A. Recent advances in the management of poisoning. Ther Drug Monit 2002; 24:150-155.
  • Teece S, Hogg K. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Glucagon in tricyclic overdose. Emerg Med J 2003; 20:264-265.
  • Vrijlandt PJ, Bosch TM, Zijlstra JG, Tulleken JE, Ligtenberg JJ, van der Werf TS. Sodium bicarbonate infusion for intoxication with tricyclic antidepressives: recommended inspite of lack of scientific evidence. Ned Tijdschr Geneeskd 2001; 145:1686-1689.
  • Belen B, Akman A, Yüksel N, Dilsiz G, Yenicesu I, Olguntürk R A case report of amitriptyline poisoning successfully treated with the application of plasma exchange. Ther Apher Dial 2009; 13:147-149.
  • Liang HK. Clinical evaluation of the poisoned patient and toxic syndromes. Clin Chem 1996; 42:1350-1355.
  • Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th edition. Baltimore, Wolters Lippincott Williams & Wilkins, 2009.
  • Kiyatkin EA, Sharma HS Acute methamphetamine intoxication brain hyperthermia, blood-brain barrier, brain edema, and morphological cell abnormalities. Int Rev Neurobiol 2009; 88:65-100.
  • Greene SL, Dargan PI, Jones AL. Acute poisoning: understanding 90% of cases in a nutshell. Postgrad Med J 2005; 81:204-216.
  • Zimmerman JL. Poisonings and overdoses in the intensive care unit: general and specific management issues. Crit Care Med 2003; 31:2794-2801.
  • Boyle JS, Bechtel LK and Holstege CP. Management of the critically poisoned patient. Scand J Trauma Resusc Emerg Med 2009; 17:29.
  • Yamamoto BK, Moszczynska A, Gudelsky GA. Amphetamine toxicities: classical and emerging mechanisms. Ann N Y Acad Sci 2010;1187:101-121.
  • Salzman C. The benzodiazepine controversy: therapeutic effects versus dependence, withdrawal, and toxicity. Harv Rev Psychiatry 1997; 4:279-282.
  • Worthley LI. Clinical toxicology: part I. Diagnosis and management of common drug overdosage. Crit Care Resusc 2002; 4:192-215.
  • Isbister GK, O'Regan L, Sibbritt D, Whyte IM. Alprazolam is relatively more toxic than other benzodiazepines in overdose. Br J Clin Pharmacol 2004; 58:88-95.
  • Smith KM, Larive LL, Romanelli F. Club drugs: methylenedioxymethamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. Am J Health Syst Pharm 2002; 59:1067-1076.
  • Thomson JS, Donald C, Lewin K. Use of Flumazenil in benzodiazepine overdose. Emerg Med J 2006; 23:162.
  • White JM, Irvine RJ. Mechanisms of fatal opioid overdose. Addiction 1999; 94:961- 972.
  • Hutchins KD, Pierre-Louis PJ, Zaretski L, Williams AW, Lin RL, Natarajan GA. Heroin body packing: three fatal cases of intestinal perforation. J Forensic Sci 2000; 45:42- 47.
  • Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Crit Care 2008; 12:202.
  • Henry JA. Management of drug abuse emergencies. J Accid Emerg Med 1996; 13:370-372.
  • Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S et al. Acute organophosphate poisoning in university hospital emergency room patients. Intern Med 2007; 46:965-969.
  • Moretto A. Experimental and clinical toxicology of anticholinesterase agents. Toxicol Lett 1998; 102-103:509-513.
  • Wagner SL. Diagnosis and treatment of organophosphate and carbamate intoxication. Occup Med 1997; 12:239-249.
  • Gunduz A, Turedi S, Russell RM, Ayaz FA. Clinical review of grayanotoxin/mad honey poisoning past and present. Clin Toxicol (Phila) 2008; 46:437-442.
  • Pawar KS, Bhoite RR, Pillay CP, Chavan SC, Malshikare DS, Garad SG. Continuous pralidoxime infusion versus repeated bolus injection to treat organophosphorus pesticide poisoning: a randomised controlled trial. Lancet 2006; 368:2136-2141.

Psikiyatride Sık Karşılaşılan Toksik Sendromlar

Year 2010, Volume: 2 Issue: 4, 532 - 571, 01.12.2010

Abstract

Psikiyatride zehirlenmeler ve toksik maddelere maruz kalma, mortalite ve morbiditenin önemli bir sebebidir. Sık karşılaşılan bu durumlar, bilinen ilaçların aşırı dozları veya ilaç etkileşimlerinin yanı sıra, yasa dışı madde kullanımı, intihar girişimi veya kazara maruziyete kadar değişen klinik senaryoları kapsamaktadır. Bu hastaların klinik değerlendirilmesi ve tedavisi önemli zorluklar taşımaktadır. Hızlı stabilizasyon ve resusitasyonun yanı sıra major toksik sendromların tanınması, doğru tanı ve tedavi için önemlidir. Bu yazıda özgül zehirlenme örüntülerini oluşturan sık karşılaşılan klinik tablolar (toksik sendromlar) tanımlanmıştır. Sık karşılaşılan toksik sendromlar arasında serotonin sendromu, nöroleptik malign sendrom, antikolinerjik, sempatomimetik, opioid, sedatif hipnotik ve kolinerjik toksik sendromlar yer almaktadır. Bu sendromların tümüne psikiyatrik bulgu ve belirtiler eşlik etmektedir. Erken tanı ve uygun tedavi hızla başlanırsa, hastaların büyük çoğunluğunda olumlu sonuçlar alınabilmektedir.

References

  • Erickson TB, Thompson TM, Lu JJ. The approach to the patient with an unknown overdose. Emerg Med Clin North Am 2007; 25:249-281.
  • Isbister GK, Buckley NA, Whyte IM. Serotonin toxicity: a practical approach to diagnosis and treatment. Med J Aust 2007; 187:361-365..
  • Dvir Y, Smallwood P. Serotonin syndrome: a complex but easily avoidable condition. Gen Hosp Psychiatry 2008; 30:284–287.
  • Attar-Herzberg D, Apel A, Gang N, Dvir D, Mayan H. The serotonin syndrome: initial misdiagnosis. Isr Med Assoc J 2009; 11:367-370.
  • Isbister KG, Bowe JS, Dawson A, Whyte MI. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. Clin Toxicol 2004; 42:277-285.
  • Guo SL, Wu TJ, Liu CC, Ng CC, Chien CC, Sun HL. Meperidine-induced serotonin syndrome in a susceptible patient. Br J Anaesth 2009; 103:369-370.
  • Sansone RA, Sansone LA. Tramadol: seizures, serotonin syndrome, and coadministered antidepressants. Psychiatry (Edgmont) 2009; 6:17-21.
  • Sun-Edelstein C, Tepper SJ, Shapiro RE. Drug-induced serotonin syndrome: a review. Expert Opin Drug Saf 2008; 7:587-596.
  • Gillman PK. CNS toxicity involving methylene blue: the exemplar for understanding and predicting drug interactions that precipitate serotonin toxicity. J Psychopharmacol 2010, doi:10.1177/0269881109359098.
  • Gillman PK. A review of serotonin toxicity data: implications for the mechanisms of antidepressant drug action. Biol Psychiatry 2006; 59:1046-1051.
  • Gillman PK. A systematic review of the serotonergic effects of mirtazapine in humans: implications for its dual action status. Hum Psychopharmacol 2006; 21:117- 125.
  • Isbister GK, Buckley NA. The pathophysiology of serotonin toxicity in animals and humans: Implications for diagnosis and treatment. Clin Neuropharmacol 2005; 28:205-214.
  • Freijo Guerrero J, Tardón Ruiz de Gauna L, Gómez JJ, Aguilera Celorrio L. Serotonin syndrome after administration of mirtazapine in a critical care unit. Rev Esp Anestesiol Reanim 2009; 56:515-516.
  • Gillman PK. Is there sufficient evidence to suggest cyclobenzaprine might be implicated in causing serotonin toxicity? Am J Emerg Med 2009; 27:509-510.
  • Lane R, Baldwin D. Selective serotonin reuptake inhibitor induced serotonin syndrome: review. J Clin Psychopharmacol 1997; 17:208-221.
  • Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003; 96:635-642.
  • Sternbach H. The serotonin syndrome. Am J Psychiatry 1991; 148:705-713.
  • Nisijima K, Yoshino T, Yui K, Katoh S. Potent serotonin (5-HT)(2A) receptor antagonists completely prevent the development of hyperthermia in an animal mo- del of the 5-HT syndrome. Brain Res 2001; 890:23-31.
  • Birmes P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003; 168: 1439-1442.
  • Isbister GK, Downes F, Whyte IM. Olanzapine and serotonin toxicity. Psychiatry Clin Neurosci 2003; 57:244.
  • Odagaki Y. Atypical neuroleptic malignant syndrome or serotonin toxicity associated with atypical antipsychotics? Curr Drug Saf 2009; 4:84-93.
  • Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005; 352:1112-1120.
  • Graudins A, Stearman A, Chan B. Treatment of the serotonin syndrome with cyproheptadine. J Emerg Med 1998; 16:615-619.
  • Graham PM. Successful treatment of the toxic serotonin syndrome with chlorpromazine. Med J Aust 1997; 166:166-167.
  • Boddy R, Dowsett RP, Jeganathan D. Sublingual olanzapine for the treatment of serotonin syndrome. Clin Toxicol 2006; 44:426.
  • Adityanjee, Aderibigbe YA, Matthews T. Epidemiology of neuroleptic malignant syndrome. Clin Neuropharmacol 1999; 22:151-158.
  • Delay J, Deniker P. Drug-induced extra-pyramidal syndromes. In Handbook of Clinical Neurology. Vol. 6: Diseases of the Basal Ganglia (Eds PS Vinken, GW Bruyn): 248–266. North-Holland, New York, Elsevier, 1968.
  • Sarkar P, Natarajan C, Gode N. Prevalence of neuroleptic malignant syndrome in 672 consecutive male in-patients. Indian J Psychiatry 2009; 51:202-205.
  • Haddad PM, Dursun SM. Neurological complications of psychiatric drugs: clinical features and management. Hum Psychopharmacol. 2008; 23(Suppl 1):15-26.
  • Trollor JN, Chen X, Sachdev PS. Neuroleptic malignant syndrome associated with atypical antipsychotic drugs. CNS Drugs 2009; 23:477-492.
  • Caroff SN, Rosenberg H, Mann SC, Campbell EC, Sullivan KA. Neuroleptic malignant syndrome in the critical care unit. Crit Care Med 2002; 30:2609 –2610.
  • Lu TC, Chu PL, Wu CS, Tsai KC, Chen WJ. Neuroleptic malignant syndrome after the use of venlafaxine in a patient with generalized anxiety disorder. J Formos Med Assoc 2006; 105:90-93.
  • Langlow JR, Alarcon RD. Trimipramine-induced neuroleptic malignant syndrome after transient psychogenic polydipsia in one patient. J Clin Psychiatry 1989; 50:144- 145.
  • Gupta S, Racaniello AA. Neuroleptic malignant syndrome associated with amoxapine and lithium in an older adult. Ann Clin Psychiatry 2000; 12:107-109.
  • Tsai HC, Kuo PH, Yang PC. Fever, consciousness disturbance, and muscle rigidity in a 68-year-old man with depressive disorder. Chest 2003; 124:1598-1601.
  • Goldberg RJ. Selective serotonin reuptake inhibitors: infrequent medical adverse effects. Arch Family Med 1998; 7:78–84.
  • Ong KC, Chew EL, Ong YY. Neuroleptic malignant syndrome without neuroleptics. Singapore Med J 2001; 42:85-88.
  • Iwuagwu CU, Riley D, Bonoma RA. Neuroleptic malignant-like syndrome in an elderly patient caused by abrupt withdrawal of tolcapone, a-catechol-o-methyl transferase inhibitor. Am J Med 2000; 108:517-518.
  • Chandran GJ, Mikler JR, Keegan DL. Neuroleptic malignant syndrome: case report and discussion. CMAJ 2003; 169:439-442.
  • Berardi D, Amore M, Keck PE Jr, Troia M, Dell'Atti M. Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: a case-control study. Biol Psychiatry 1998; 44:748-754.
  • Strawn JR, Keck PE, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry 2007; 164:870-876.
  • Isbister GK, Buckley NA. Clomipramine and neuroleptic malignant syndrome: literature on adverse reactions to psychotropic drugs continues to confuse. BMJ 2005; 330:790-791.
  • Margetić B, Margetić BA. Neuroleptic malignant syndrome and its controversies. Pharmacoepidemiol Drug Saf 2010; 19:429-435.
  • Serrano-Duenas M. Neuroleptic malignant syndrome-like, or —dopaminergic malignant syndrome — due to levodopa therapy withdrawal. Clinical features in 11 patients. Parkinsonism Relat Disord 2003; 9:175-178.
  • Kishida I, Kawanishi C, Furuno T, Kato D, Ishigami T, Kosaka K. Association in Japanese patients between neuroleptic malignant syndrome and functional polymorphisms of the dopamine D(2) receptor gene. Mol Psychiatry.2004; 9:293-298.
  • Zivković M, Mihaljević-Peles A, Sagud M, Silić A, Mihanović M. The role of CYP2D6 and TaqI A polymorphisms in malignant neuroleptic syndrome: two case reports with three episodes. Psychiatr Danub 2010; 22:112-116.
  • Pelonero AL, Levenson JL, Pandurangi AK. Neuroleptic malignant syndrome. Psychiatr Serv 1998; 49:1163-1172.
  • Hall RC, Appleby B, Hall RC. Atypical neuroleptic malignant syndrome presenting as fever of unknown origin in the elderly. South Med J 2005; 98:114-117.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision. Washington, DC, American Psychiatric Association, 2000.
  • Pope HG Jr, Cole JO, Choras PT, Fulwiler CE. Apparent neuroleptic malignant syndrome with clozapine and lithium. J Nerv Ment Dis 1986; 174:493-495.
  • Mathews T, Aderibigbe YA. Proposed research diagnostic criteria for neuroleptic malignant syndrome. Int J Neuropsychopharmacol 1999; 2:129-144.
  • Nierenberg D, Disch M, Manheimer E, Patterson J, Ross J, Sivestri G, et al. Facilitating prompt diagnosis and treatment of the neuroleptic malignant syndrome. Clin Pharmacol Ther 1991; 50:580-586.
  • Adityangee, Mathews T, Aderibigbe YA. Proposed research diagnostic criteria for neuroleptic malignant syndrome. Int J Neuropsychopharm 1999; 2:129-144.
  • Farver DK. Neuroleptic malignant syndrome induced by atypical antipsychotics. Expert Opin Drug Saf 2003; 2:21-35.
  • Addonozio G, Susman VL, Roth SD. Neuroleptic malignant syndrome: review and analysis of 115 cases. Biol Psychiatry 1987; 22:1004-1020.
  • Meterissian GB. Risperidone-induced neuroleptic malignant syndrome: a case report and review. Can J Psychiatry 1996; 41:52-54.
  • Sachdev P, Kruk J, Kneebone M, Kissane D. Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. J Clin Psychopharmacol 1995; 15:365
  • Ananth J, Parameswaran S, Gunatilake S, Burgoyne K, Sidhom T. Neuroleptic malignant syndrome and atypical antipsychotic drugs. J Clin Psychiatry 2004; 65:464-470.
  • Seitz DP. Diagnostic uncertainty in a case of neuroleptic malignant syndrome. Can J Emerg Med 2005; 7:266-272.
  • Haddad PM, Dursun SM. Neurological complications of psychiatric drugs: clinical features and management. Hum Psychopharmacol. 2008; 23 (Suppl 1):15-26.
  • Taniguchi N, Tanii H, Nishikawa T. Classification system of complications in neuroleptic malignant syndrome. Methods Find Exp Clin Pharmacol 1997; 19:193- 199.
  • Shalev A, Hermesh H, Munitz H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry 1989; 50:18-25.
  • Labuda A, Cullen N. Brain injury following neuroleptic malignant syndrome: case report and review of the literature. Brain Inj 2006; 20:775-778.
  • Akhaddar A, Karouache A, Elmostarchid B, Boucetta M. Bilateral chronic subdural haematoma misdiagnosed as neuroleptic malignant syndrome. Emerg Med J 2010; 27:233.
  • Birmes P, Coppin D, Schmitt L, Lauque D. Serotonin syndrome: a brief review. CMAJ 2003; 168:1439-1442.
  • Simon HB. Hyperthermia. N Engl J Med 1993; 329:483-487.
  • Tsutsumi Y, Yamamoto K, Matsuura S, Hata S, Sakai M, Shirakura K. The treatment of neuroleptic malignant syndrome using dantrolene sodium. Psychiatry Clin Neurosci 1998; 52:433-438.
  • Brown TM: Clozapine, neuroleptic malignant syndrome, and pancerebellar syndrome. Psychosomatics 1999; 40:518-520.
  • Storm C, Gebker R, Krüger A, Nibbe L, Schefold JC, Martens F et al. A rare case of neuroleptic malignant syndrome presenting with serious hyperthermia treated with a non-invasive cooling device: a case report. J Med Case Reports 2009; 3:6170.
  • Kaufman KR, Levitt MJ, Schiltz, Sunderram J. Neuroleptic malignant syndrome and serotonin syndrome in the critical care setting: case analysis. Ann Clin Psychiatry. 2006; 18:201-204.
  • Rosenbaum HK, Miller JD. Malignant hyperthermia and myotonic disorders. Anesthesiol Clin North Am 2002; 20:623-664.
  • Ihara M, Kohara N, Urano F, , Ichinose H, Takao S, Nishida T, et al. Neuroleptic malignant syndrome with prolonged catatonia in a dopa-responsive dystonia patient. Neurology 2002; 59:1102-1104.
  • Mannaioni G., Baronti R, Moroni F. Gastrointestinal bleeding and massive liver damage in neuroleptic malignant syndrome. Ther Clin Risk Manag 2005; 1:225-229.
  • Donegan JH, Danegan WL, Cohen EB. Massive hepatic necrosis associated with dantrolene therapy. Digest Dis Sci 1978; 23:48–52.
  • Burns MJ, Linden CH, Graudins A, Brown RM, Fletcher KE. A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning. Ann Emerg Med 2000; 35:374-381.
  • Felder CC. Muscarinic acetylcholine receptors: signal transduction through multiple effectors. FASEB J 1995; 9:619-625.
  • Ishii M, Kurachi Y. Muscarinic acetylcholine receptors. Curr Pharm Des 2006; 12:3573
  • Bolden C, Cusack B, Richelson E. Antagonism by antimuscarinic and neuroleptic compounds at the five cloned human muscarinic cholinergic receptors expressed in Chinese hamster ovary cells. J Pharmacol Exp Ther 1992; 260:576-580.
  • Spina SP, Taddei A. Teenagers with Jimson weed (Datura stramonium) poisoning. CJEM 2007; 9:467-468.
  • Krenzelok EP, Leikin JB. Approach to the poisoned patient. Dis Mon 1996; 42:509- 607.
  • Woolf AD, Erdman AR, Nelson LS, Caravati EM, Cobaugh DJ, Booze LL, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of- hospital management. Clin Toxicol (Phila) 2007; 45:203-233.
  • Pierog JE, Kane KE, Kane BG, Donovan JW, Helmick T. Tricyclic antidepressant toxicity treated with massive sodium bicarbonate. Am J Emerg Med 2009; 27:1168.e3-7.
  • Jones AL, Dargan PI. Churchill’s Textbook of Toxicology. Edinburgh, Churchill- Livingstone, 2001.
  • Harrigan RA and Brady WJ. ECG abnormalities in tricyclic antidepressant ingestion. Am J Emerg Med 1999; 17:387-393.
  • Ozbilen M, Adams CE. Systematic overview of Cochrane reviews for anticholinergic effects of antipsychotic drugs. J Clin Psychopharmacol 2009; 29:141-146.
  • Bolden C, Cusack B, Richelson E. Antagonism by antimuscarinic and neuroleptic compounds at the five cloned human muscarinic cholinergic receptors expressed in Chinese hamster ovary cells. J Pharmacol Exp Ther 1992; 260:576-580.
  • Sharma AN, Hexdall AH, Chang EK, Nelson LS, Hoffman RS. Diphenhydramine- induced wide complex dysrhythmia responds to treatment with sodium bicarbonate. Am J Emerg Med 2003; 21:212-215.
  • Irioka T, Yamanami A, Uchida N, Iwase M, Yasuhara H, Mizusawa H. Opsoclonus caused by diphenhydramine self-poisoning. J Neuroophthalmol 2009; 29:72-73.
  • Jones A. Recent advances in the management of poisoning. Ther Drug Monit 2002; 24:150-155.
  • Teece S, Hogg K. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Glucagon in tricyclic overdose. Emerg Med J 2003; 20:264-265.
  • Vrijlandt PJ, Bosch TM, Zijlstra JG, Tulleken JE, Ligtenberg JJ, van der Werf TS. Sodium bicarbonate infusion for intoxication with tricyclic antidepressives: recommended inspite of lack of scientific evidence. Ned Tijdschr Geneeskd 2001; 145:1686-1689.
  • Belen B, Akman A, Yüksel N, Dilsiz G, Yenicesu I, Olguntürk R A case report of amitriptyline poisoning successfully treated with the application of plasma exchange. Ther Apher Dial 2009; 13:147-149.
  • Liang HK. Clinical evaluation of the poisoned patient and toxic syndromes. Clin Chem 1996; 42:1350-1355.
  • Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th edition. Baltimore, Wolters Lippincott Williams & Wilkins, 2009.
  • Kiyatkin EA, Sharma HS Acute methamphetamine intoxication brain hyperthermia, blood-brain barrier, brain edema, and morphological cell abnormalities. Int Rev Neurobiol 2009; 88:65-100.
  • Greene SL, Dargan PI, Jones AL. Acute poisoning: understanding 90% of cases in a nutshell. Postgrad Med J 2005; 81:204-216.
  • Zimmerman JL. Poisonings and overdoses in the intensive care unit: general and specific management issues. Crit Care Med 2003; 31:2794-2801.
  • Boyle JS, Bechtel LK and Holstege CP. Management of the critically poisoned patient. Scand J Trauma Resusc Emerg Med 2009; 17:29.
  • Yamamoto BK, Moszczynska A, Gudelsky GA. Amphetamine toxicities: classical and emerging mechanisms. Ann N Y Acad Sci 2010;1187:101-121.
  • Salzman C. The benzodiazepine controversy: therapeutic effects versus dependence, withdrawal, and toxicity. Harv Rev Psychiatry 1997; 4:279-282.
  • Worthley LI. Clinical toxicology: part I. Diagnosis and management of common drug overdosage. Crit Care Resusc 2002; 4:192-215.
  • Isbister GK, O'Regan L, Sibbritt D, Whyte IM. Alprazolam is relatively more toxic than other benzodiazepines in overdose. Br J Clin Pharmacol 2004; 58:88-95.
  • Smith KM, Larive LL, Romanelli F. Club drugs: methylenedioxymethamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. Am J Health Syst Pharm 2002; 59:1067-1076.
  • Thomson JS, Donald C, Lewin K. Use of Flumazenil in benzodiazepine overdose. Emerg Med J 2006; 23:162.
  • White JM, Irvine RJ. Mechanisms of fatal opioid overdose. Addiction 1999; 94:961- 972.
  • Hutchins KD, Pierre-Louis PJ, Zaretski L, Williams AW, Lin RL, Natarajan GA. Heroin body packing: three fatal cases of intestinal perforation. J Forensic Sci 2000; 45:42- 47.
  • Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Crit Care 2008; 12:202.
  • Henry JA. Management of drug abuse emergencies. J Accid Emerg Med 1996; 13:370-372.
  • Yurumez Y, Durukan P, Yavuz Y, Ikizceli I, Avsarogullari L, Ozkan S et al. Acute organophosphate poisoning in university hospital emergency room patients. Intern Med 2007; 46:965-969.
  • Moretto A. Experimental and clinical toxicology of anticholinesterase agents. Toxicol Lett 1998; 102-103:509-513.
  • Wagner SL. Diagnosis and treatment of organophosphate and carbamate intoxication. Occup Med 1997; 12:239-249.
  • Gunduz A, Turedi S, Russell RM, Ayaz FA. Clinical review of grayanotoxin/mad honey poisoning past and present. Clin Toxicol (Phila) 2008; 46:437-442.
  • Pawar KS, Bhoite RR, Pillay CP, Chavan SC, Malshikare DS, Garad SG. Continuous pralidoxime infusion versus repeated bolus injection to treat organophosphorus pesticide poisoning: a randomised controlled trial. Lancet 2006; 368:2136-2141.
There are 113 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Vesile Altınyazar This is me

Publication Date December 1, 2010
Published in Issue Year 2010 Volume: 2 Issue: 4

Cite

AMA Altınyazar V. Psikiyatride Sık Karşılaşılan Toksik Sendromlar. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2010;2(4):532-571. doi:10.18863/pgy.133428

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