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CASE REPORT article
Front. Psychiatry
Sec. Adolescent and Young Adult Psychiatry
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1560248
This article is part of the Research TopicAdolescent Emotional Disorders and Suicide Self-Harm Crisis InterventionView all 10 articles
Neuroleptic Malignant Syndrome in a 15-Year-Old Female Following of Psychotropic Drugs
Provisionally accepted- First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
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Background: Neuroleptic Malignant Syndrome (NMS) is a rare but life-threatening neurological emergency associated with dopamine receptor blockade. It is characterized by hyperthermia, autonomic instability, muscle rigidity, and altered mental status. Early recognition and intervention are crucial to prevent severe complications. Case Presentation: We report a case of a 15-year-old female diagnosed with major depressive disorder (MDD), with a body mass index (BMI) of 13.7, who developed severe NMS with rapid-onset rhabdomyolysis and vocal cord dysfunction following an overdose of quetiapine, sertraline, and lorazepam. The clinical presentation posed a diagnostic challenge due to overlapping features with serotonin syndrome. Despite aggressive supportive care, she developed acute kidney injury secondary to rhabdomyolysis, necessitating plasmapheresis and hemoperfusion. Additionally, post-extubation vocal cord dysfunction led to aspiration pneumonia, requiring prolonged airway management. Conclusion: This case highlights the complexity of diagnosing NMS in the context of polypharmacy , the potential for rapid rhabdomyolysis, and the rarity of vocal cord involvement. The successful use of plasmapheresis as an adjunct therapy suggests a possible role in severe NMS with organ dysfunction. Early recognition and individualized management remain key to optimizing outcomes.
Keywords: Neuroleptic Malignant Syndrome, Antipsychotic overdose, Rhabdomyolysis, vocal cord dysfunction, Plasmapheresis
Received: 14 Jan 2025; Accepted: 15 Apr 2025.
Copyright: © 2025 Fan, Yi, Zhang and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yingying Shen, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
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