Abstract

Neuroleptic Malignant Syndrome (NMS); is a rare, idiosyncratic adverse reaction which usually occurs with antipsychotic treatment. It is defined as fever, autonomic instability, extrapyramidal syndrome and altered mental state. Elevated serum creatine kinase level, impaired liver and kidney function tests, leukocytosis, and electrolyte disturbance may be the accompanying laboratory features. In this case report, we present the manifestation of NMS in a 21-year-old-man with bipolar disorder, after addition of paliperidone palmitate and lithium. To the best of our knowledge, this case is the first to report the NMS arising from the use of paliperidone palmitate and lithium in a patient with bipolar disorder.

Key words: neuroleptic malignant syndrome, paliperidone palmitate, lithium, valproate