Case Report

Loxapine in the Treatment of Manic and Psychotic Symptoms in an Individual Intolerant to Multiple Mood-Stabilizing and Antipsychotic Medications

Table 1

Adverse event review of symptoms.

ConditionCore symptoms/signs

Drug related eosinophilia and systemic symptoms (DRESS) [2, 3](i) Fever (38 to 40 degrees Celsius) [3]
(ii) Skin rash (diffuse, polymorphic) [3]
(iii) Liver injury [3]
(iv) Eosinophilia [3]
(v) Enlarged lymph nodes in at least 2 body sites [3]

Neuroleptic malignant syndrome (NMS) [1](i) Recent use of dopamine receptor antagonist (antipsychotic) [27, 28]
(ii) Central nervous system (CNS) symptoms (drowsiness, mutism, confusion, and coma) [27, 28]
(iii) Severe “lead pipe” muscle rigidity/other extrapyramidal effects (bradykinesia, tremor, and abnormal movements/posture) [27, 28]
(iv) Hyperthermia [27, 28]
(v) Autonomic dysfunction (labile blood pressure and tachycardia) [27, 28]

Diabetes insipidus [46](i) Polyuria [4, 5]
(ii) Polydipsia [4, 5]
(iii) Signs of dehydration (e.g., dry lips, orthostatic hypotension, weakness, dizziness, and fatigue) [4, 5]
(iv) Signs of hypernatremia (serum sodium greater than 145 mEq/L), e.g., restlessness, agitation, decreased deep tendon reflexes, and seizures [4, 5]

mEq/L: milliequivalents per liter.