Posted by ed_uk2010 on January 8, 2015, at 10:59:32
In reply to Latuda 101 fever. Should I continue?, posted by Phil on January 8, 2015, at 10:17:18
> OK, Zyprexa sent me to the hospital for 6 days of 103-104 fever. Six days! They ran every test in the book and the attending doc dx'd Fever NOS. My psychiatrist said NMS (Neuroleptic Malignant Syndrome).
Neuroleptic malignant syndrome is the most serious form of antipsychotic-induced pyrexia but antipsychotics can also cause an elevated temperature not associated with NMS. NMS causes fever partly due to the presence of severe muscle rigidity - which generates a lot of heat, but also because antipsychotics impair temperature regulation. If there is no muscle rigidity, other causes of fever need to be looked into. In this situation, the antipsychotic may be contributing to the fever but may not be the only cause.
In the absence of any other symptoms, fever is not NMS, but needs to be monitored closely in case it progresses to NMS. It seems that you do have other symptoms but they are currently vague. A medical assessment is therefore needed. NMS is diagnosed based on the combination of fever and widespread muscle rigidity, stiffness and/or tension. Mental state changes (often confusion) may be present. Sweating and increased pulse rate are common. Blood pressure may fluctuate up and down.
In the absence of NMS, Zyprexa, Latuda and other antipsychotics can cause fever via impaired temperature regulation. Zyprexa, but not Latuda, is anticholinergic, which may lead to a further increase in temperature due to reduced sweating. D2 antagonists.
Impaired temperate regulation means that the body is no longer efficient at maintaining its usual (almost) constant temperature. The body temperature is now affected by the environment. In cold weather, those on APs (usually the elderly), are at risk of hypothermia. In hot weather, there is a risk of hyperthermia/fever. In the presence of infection/illness, the risk of an abnormal body temp may be increased by APs.
Is Latuda your only antipsychotic? Combinations of antipsychotics and high doses present a higher risk than low dose of single antipsychotics.
>move slow and I ache
Does it feel like a viral infection to you? Or are you muscles stiff and rigid? Achy muscles, rather than the typical NMS tension/rigidly are normally due to infection.
>Tylenol
Fever in NMS does not respond to Tylenol, but it can be reduced my cooling measures and muscle relaxants. Fever due to infections normally responds to Tylenol, and better still to ibuprofen (in the absence of contraindications to ibuprofen).
>My question is do I run this experiment again tonight?
No. Your fever last night was too high, particularly considering your bad response to Zyprexa in the past. You need to see a doctor. It's possible that you have a combination of a viral infection plus impaired temperature regulation due to the antipsychotic, which is causing more fever than you would normally experience. I think you should continue Tylenol for a few days until the muscle aching goes away (or ibuprofen, if appropriate). The doctor should take your pulse, BP, temperature and examine you.
You're not on a high dose of Latuda but I recall you taking another antipsychotic, is this still the case or did you stop and start Latuda instead? You may need to stop treatment with Latuda temporarily at least, so you need advice from a professional here.
poster:ed_uk2010
thread:1074947
URL: http://www.dr-bob.org/babble/20150102/msgs/1074950.html