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Case Reports in Psychiatry
Volume 2011, Article ID 258172, 2 pages
http://dx.doi.org/10.1155/2011/258172
Case Report

Extensive Deep Venous Thrombosis in a Patient with Neurolept Malignant Syndrome despite Being on Prophylaxis

Department of Internal Medicine, St. Mary's Health Center, St. Louis, MO 63117, USA

Received 21 June 2011; Accepted 18 August 2011

Academic Editor: C. Lançon

Copyright © 2011 Jerrin C. Mathew et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The risk of venous thromboembolism (VTE) in patients with Neuroleptic malignant syndrome (NMS) and those on antipsychotic medications is well established. We present here a case whereby the patient had NMS and developed extensive deep venous thrombosis (DVT) despite being on standard DVT Prophylaxis. Our case illustrates that empiric intravenous heparin for the initial few days after the onset of NMS may be considered in those with high risk of VTE, as in such patients standard DVT prophylaxis may not be sufficient. To standardize as to which patients with NMS would be at the highest risk of VTE while on standard DVT prophylaxis, the role of a standardized scoring system and a double-blind randomized trial in the future would probably be beneficial.