Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient who developed neuroleptic malignant syndrome (NMS) from the use of several neuroleptic agents and the therapeutic interventions used to reverse the syndrome are described, and the clinical presentation and treatment of NMS are reviewed. Fever, leukocytosis, seizures, delirium, and elevated serum creatine phosphokinase levels developed in a 17-year-old girl who was receiving perphenazine and haloperidol. The patient was admitted to a hospital for treatment of atypical psychosis and received haloperidol and, later, thioridazine. Autonomic disturbances, altered consciousness, and muscular rigidity developed. Thioridazine was discontinued in favor of perphenazine because of anticholinergic adverse effects. Symptoms persisted despite treatment with benztropine and diphenhydramine. After the diagnosis of NMS was made, all neuroleptics were discontinued, and the patient began therapy with dantrolene sodium and bromocriptine. Dramatic improvement in the patient's condition followed. NMS has four characteristic signs: hyperthermia, muscular rigidity, altered consciousness, and autonomic dysfunction. Mechanisms believed to cause NMS include alteration of central neuoregulatory mechanisms and neuroleptic-induced imbalance between central dopaminergic and gamma-aminobutyric acid neurotransmitter systems. Bromocriptine, amantadine, dantrolene sodium, and electroconvulsive therapy have been used effectively in the treatment of NMS. NMS is a rare but potentially fatal adverse drug reaction that occurs in situations that make diagnosis difficult. Dramatic, favorable responses can be achieved with early diagnosis and appropriate treatment.
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PMID:Diagnosis and treatment of neuroleptic malignant syndrome. 324 Jun 62

On the basis of case reports and small non-comparative series it has been suggested that thioridazine has greater cardiotoxicity in overdose. Limited evidence also suggests an increased association with sudden death in therapeutic doses. The aim of our study is to examine the clinical and electrocardiographic features associated with neuroleptic poisoning and compare thioridazine with other neuroleptics. Consecutive adult patients with neuroleptic poisoning presenting to metropolitan hospitals in Newcastle between 1987 and 1993 were studied. The main outcome measures examined were ECG changes (QRS, QT and QTc intervals), arrhythmias, seizures, degree of sedation, heart rate and blood pressure. Two-hundred ninety-nine patients had ingested thioridazine (104), chlorpromazine (69), trifluoperazine (36), pericyazine (35), haloperidol (33), prochlorperazine (18), fluphenazine (8), or other neuroleptics (7). Sixteen patients had ingested more than one neuroleptic and were excluded from comparative analysis. Thioridazine was more likely to cause tachycardia (odds ratio 1.7, 95% CI 1.1-2.9, p = 0.03), a prolonged QT interval (odds ratio 5.2, 95% CI 1.6-17.1, p = 0.006), prolonged QTc > 450 ms1/2 (odds ratio 4.7, 95% CI 2.7-7.9, p = 0.001), a widened QRS (> 100 ms) (odds ratio 3.1, 95% CI 1.5-6.3, p = 0.001) and arrhythmias (odds ratio infinity, 95% CI 2.4- infinity, p = 0.004). There were no significant differences in the odds of coma (odds ratio 0.5 (0.2-1.5)), hypotension (odds ratio 0.9 (0.4-1.9)) or seizures (odds ratio 3.9 (0.3-43.5)). Adjustment for age, sex, dose ingested and co-ingestion of tricyclic antidepressants or lithium had no major effect on the odds ratios observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiotoxicity more common in thioridazine overdose than with other neuroleptics. 863 4

Neuroleptic and anticonvulsant drugs are used to reduce the occurrence of aberrant behaviors, seizures, or both in individuals with mental retardation. However, their use may disrupt the learning of desired skills, and the extent to which anatomical (e.g., microencephaly) or biochemical abnormalities or both in such individuals alter the effects of drugs on learning is not known. In this study, the effects of neuroleptics and anticonvulsants on learning and performance in a repeated acquisition task in methylazoxymethanol-induced microencephalic and saline control rats were assessed. Thioridazine was more potent in microencephalic rats than in control rats in increasing errors and decreasing response rates. Clozapine was equally potent in both microencephalic and control rats in increasing errors and decreasing response rates. The effect of carbamazepine was biphasic in both rat groups: Low doses decreased errors and increased response rates, whereas higher doses did the opposite.
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PMID:Effects of neuroleptic and anticonvulsant drugs on repeated acquisition learning in microencephalic and normal rats. 938 59