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Emergent Neuroleptic Hypersensitivity as a Herald of Presenile Dementia

Received March 30, 2000; revised July 7, 2000; accepted July 21, 2000. From the Departments of Neurology and Psychiatry and Biobehavioral Sciences, University of California at Los Angeles School of Medicine, and Psychiatry Service, West Los Angeles VA Medical Center, Los Angeles, California; and the University of Texas Southwestern Medical School, Dallas, Texas. Address correspondence to Dr. Mendez, Neurobehavior Unit (691/116AF), West Los Angeles VA Medical Center, 11301 Wilshire Blvd., Los Angeles, CA 90073. E-mail: mmendez{at}ucla.edu

Neuroleptic hypersensitivity is characteristic of dementia with Lewy bodies (DLB) but not of other dementias. The authors report 5 patients with psychotic mood disorders and long-standing antipsychotic drug therapy. As they reached 50 to 60 years of age, they unexpectedly developed hypersensitivity to these medications, with rigidity, muteness, or the neuroleptic malignant syndrome. Nearly coincident with this reaction, they developed progressive cognitive deficits consistent with frontotemporal dementia. These patients illustrate emergent neuroleptic hypersensitivity as an early manifestation of other dementias. The predisposition to neuroleptic hypersensitivity could result from depleted nigral dopaminergic neurons suggested by "smudging" of the substantia nigra pars compacta on magnetic resonance imaging.

Key Words: Neuroleptic Sensitivity • Dementia • Bipolar Disorder

This article has been cited by other articles:

				M. F. Mendez, E. C. Lauterbach, S. M. Sampson, and ANPA Committee on Research An Evidence-Based Review of the Psychopathology of Frontotemporal Dementia: A Report of the ANPA Committee on Research J Neuropsychiatry Clin Neurosci, May 1, 2008; 20(2): 130 - 149. [Abstract] [Full Text] [PDF]

				M. F. Mendez and K. M. Perryman Neuropsychiatric Features of Frontotemporal Dementia: Evaluation of Consensus Criteria and Review J Neuropsychiatry Clin Neurosci, November 1, 2002; 14(4): 424 - 429. [Abstract] [Full Text] [PDF]

				Can Neuroleptic Hypersensitivity Presage Frontotemporal Dementia? Journal Watch Psychiatry, September 5, 2001; 2001(905): 6 - 6. [Full Text]

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