Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of Parkinson's disease with neuroleptic malignant syndrome induced by Paroxetine

Yukihiro Hamada, M.D., Katsuichi Miyamoto, M.D., Yohei Inatsugi, M.D., Hidekazu Suzuki, M.D. and Susumu Kusunoki, M.D.

Department of Neurology, Kinki University School of Medicine

We present a first case of Parkinson's disease with neuroleptic malignant syndrome by Paroxetine, one of the selective serotonin reuptake inhibitor (SSRI). The patient was a 73-year-old woman who had been diagnosed as Parkinson's disease for one and half year. The severity of her disease was categorized as Hoehn & Yahr 2'nd degree and she had taken 0.25 mg/day of Pramipexole. Four days after the addition of 10 mg/day of Paroxetine for the treatment of her depression, she developed consciousness disturbance, severe muscular rigidity, tremor, fever, hyperhidrosis, incontinence and elevated serum creatine kinase level. According to diagnostic criteria, she was diagnosed as neuroleptic malignant syndrome probably induced by Paroxetine. Her clinical symptoms and laboratory data were improved seven days after intravenous drip infusion. We should recognize that SSRI could induce neuroleptic malignant syndrome in patients with Parkinson's disease.

(CLINICA NEUROL, 46: 575|578, 2006)
key words: neuroleptic malignant syndrome, Paroxetine, SSRI, Parkinson's disease, serotonin syndrome

(Received: 9-Jun-06)