SYMPOSIA

Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Poster Presentations
and conduct problems and eating behavior is mainly related to drinking rather than smoking. The association of eating behavior and
drinking is likely correlated through the medium of various psychopathologies.
Key words: Substance use, eating pattern, psychopathology, female adolescents.
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S124-5
[PP-007] Ref. No: 219
Neuroleptic malignant syndrome: A case report
Hale Yaci 1 , Esra Kaymak Koca 1 , Yasemin Uz 1 , Aysun Demir 1 , Aygun Akbay Ozşahin 2 , Fusun Mayda Domac 2
1Department of Psychiatry, Erenkoy Mental Research and Training Hospital, Istanbul, Turkey
2Department of Neurology, Erenkoy Mental Research and Training Hospital, Istanbul, Turkey
E-mail: haleyaci@yahoo.com
Summary: Neuroleptic Malignant Syndrome (NMS) is a state, which commonly presents with autonomic changes like fever exceeding
40 degrees Celsius, muscle rigidity, changes in mental status, tachypnea, and fluctuations in blood pressure. It occurs mostly due to
classical antipsychotic drugs with high potency. However, atypical antipsychotic drugs, such as fluoxetine, reserpine and phenothiazinelike
antiemetics, can also cause NMS. We present a case of a 38 year-old patient with chronic schizophrenia, who developed NMS after
ingestion of the intramuscular form of zuclopenthixol acetate 50 mg/ml twice, two days apart.
Case: A 38 year-old, single, male patient with a diagnosis of chronic schizophrenia for 18 years. While being followed up with clozapine
300 mg/d, amisulpride 200 mg/d for the last 6 months, upon oral administration of zuclopenthixol acetate 50 mg/ml (im) twice, two days
apart, by his family for an acute psychotic flare, he presented to the emergency room with sweating, progressive dysphagia, refusal of
food intake, hypersalivation, slowing of speech, dysuria, and muscle cramps. On examination, his body temperature was 39.3 degrees
Celsius, heart rate was 110 bpm, blood pressure was 120/70 mm-Hg, and the patient was tachypneic (32/min). There were no pathological
findings apart from urinary incontinence. On laboratory work-up: WBC=12700/mm 3 , CPK=3226 U/l, urea=74 mg/dl, creatinine=1.4 mg/dl,
Fe=19 U/dl. On follow up, a mild to moderate increase in leukocytosis was seen. For hydration, 2000 cc IV fluid was given as a replacement
with regards to his urinary output. All antipsychotic drugs were stopped. He was put on lorazepam 1 mg/dl because of agitation. On follow
up, his leukocyte count went back to normal, CPK level was down from 3226 to 102 consecutively. Urea and creatinine levels were 20 mg/
dl and 1.4 mg/dl, respectively. His oral intake returned to normal in 5 days; fluid replacement was continued for 3 more days. His rigidity
was still present but to a lesser extent and after 10 days the patient was discharged with clinical recovery.
Conclusion: NMS is often seen within 10 days following antipsychotic use; however, regardless of dose and duration of usage, it can
be seen at any stage of therapy. There are no cases reported in the literature like ours on oral ingestion of the intramuscular form of an
antipsychotic drug. We believe that as the number of case reports on NMS increase, this issue will be better understood.
Key words: Neuroleptic malignant syndrome, chronic schizophrenia, zuclopenthixol acetate.
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S125
[PP-008] Ref. No: 223
Treatment of clozapine induced obsessive compulsive behavior in a schizophrenic
patient with valproic acid augmentation: A case report
Fatih Canan 1 , Unsal Aydınoglu 2 , Gjergji Sinani 3
1 Bolu İzzet Baysal Ruh Sağlığı ve Hastalıkları Hastanesi, Bolu, Turkey
2 Atatürk Üniversitesi, Psikiyatri Anabilim Dalı, Erzurum, Turkey
3 Marmara Üniversitesi, Psikiyatri Anabilim Dalı, İstanbul, Turkey
E-mail: fatihcanan@gmail.com
Introduction: The comorbidity of obsessive-compulsive disorders (OCD) and schizophrenia has been documented by epidemiological
investigations. Within the multiple pathogenetic factors leading to OCD in schizophrenic patients, treatment with atypical antipsychotics
has been proposed for a significant subgroup of these patients. Herein, we report the case of a schizophrenic patient who developed
clozapine-induced obsessive compulsive symptoms that responded to valproic acid augmentation.
Case Report: A 51-year-old male patient first developed paranoid delusions and auditory and visual hallucinations at the age of 23,
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