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Geriatric Psychopharmacology: A Complex Case of Psychosis Complicated by Neuroleptic Malignant Syndrome (NMS) and Metabolic Syndrome (MetS)

  • Raj Velamoor
  • Gautham Pulagam
Chapter

Abstract

Treating psychosis in the elderly can be a significant challenge. The potential for clinical difficulty due to the complex interactions between enzymes, multiple receptor subtypes, and individual variations is highlighted. Here, we present a complex case of psychosis complicated by neuroleptic malignant syndrome and metabolic syndrome. We have outlined the relevant pharmacokinetics, pharmacodynamics, risk factors, and management strategies which can be applied when confronted with multiform cases such as the one presented here.

Keywords

Pharmacokinetics Pharmacodynamics Polypharmacy Neuroleptic malignant syndrome 

Abbreviations

ALT

Alanine transaminase

AMPK

Adenosine monophosphate-activated protein kinase

AST

Aspartate transaminase

BUN

Blood urea nitrogen

CPK

Creatine phosphokinase

CVD

Cardiovascular disease

CYP

Cytochrome P 450

GABA

Gamma-amniobutyric acid

HDL

High-density lipoprotein

LDL

Low-density lipoprotein

LFT

Liver function test

MetS

Metabolic syndrome

NMS

Neuroleptic malignant syndrome

PPAR α

Peroxisome proliferator-activated receptor alpha

SSRI

Selective serotonin reuptake inhibitors

START

Screening Tool to Alert doctors to Right Treatment

STOPP

Screening Tool of Older Person’s Prescriptions

TNFα

Tumor necrosis factor alpha

Notes

Disclosure Statement

“The authors have nothing to disclose.”

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Raj Velamoor
    • 1
    • 2
  • Gautham Pulagam
    • 3
  1. 1.Northern Ontario School of MedicineLaurentian and Lakehead UniversitySudburyCanada
  2. 2.Schulich School of MedicineWestern UniversityLondonCanada
  3. 3.Medical University of the Americas, St. Kitts and Nevis University of Toronto at MississaugaMississaugaCanada

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