抗うつ薬の内服中断により術後に悪性症候群を発症した乳房再建術の1症例

Antidepressant Discontinuation-induced Neuroleptic Malignant Syndrome：A Case Report

要旨

　悪性症候群は，発熱，意識障害，錐体外路症状，横紋筋融解症などの症状を呈する一連の症候群として定義されている。今回，抗うつ薬の自己中断によって，全身麻酔後に悪性症候群が発症し，治療した症例を経験したので報告する。

　We present a rare case of neuroleptic malignant syndrome（NMS）induced by the discontinuation of tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors（SNRIs）. The patient postoperatively met Levenson’s diagnostic criteria with symptoms including muscular rigidity, elevated creatine kinase（CK）, tachycardia, tachypnea, excessive sweating, and leukocytosis. Prompt treatment with dantrolene prevented worsening. Differential diagnoses include serotonin syndrome, encephalitis, heatstroke, and rhabdomyolysis. This case highlights the importance of thorough preoperative assessment, close postoperative monitoring, and effective communication among healthcare providers in managing NMS in patients with a history of antidepressant use.