Abstract
Neuroleptic malignant syndrome (NMS) occurs suddenly in patients treated with neuroleptic agents and involves high mortality. We report a case of NMS due to intramuscular injection of haloperidol decanoate. A 29-year-old man with paranoia schizophrenia since the age of 19 years was treated with neuroleptics. From 4 months ago, he was treated with haloperidol decanoate (50mg i.m. monthly), increased to 100mg/month. On the day before admission, he took an overdose of neuroleptics (include chlorpromazine hydrochloride 4.2g). He was transfered to our hospital due to drug intoxication. After admission, he developed NMS. After onset, haloperidol decanoate and all other neuroleptics were stopped. He was treated with dantrolene, bromocriptine, muscle relaxants, and intensive care including assisted ventilation, but his clinical condition and laboratory data did not improved for 25 days. In this case, we studied drug concentration in muscles undergoing haloperidol decanoate injection to determine the possible muscle resection for decreasing the blood concentration of the drug, but the patient recovered without muscle resection.
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