Rhabdomyolysis after Antipsychotic Use:Case Reports and Literature Review
CAO Guo-ying1, WANG Chen-guang1, CHEN Ming-hui1, ZHAO Hua-ping1, CHEN Qian2, HU Xin1
1. Department of Pharmacy, National Center of Gerontology, Evaluation of Clinical Risk and Individualized Application of Drugs, Beijing Key Laboratory, Beijing Hospital, Beijing 100730,China; 2. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
Abstract：OBJECTIVE Antipsychotic drugs are being widely used for psychiatric disorders, including schizophrenia, bipolar disorders, attention-deficit, autism, depression. Rhabdomyolysis is a rare but potentially serious adverse drug reaction to antipsychotic medicines.To evaluate rhabdomyolysis association with a range of antipsychotic medicines. METHODS Key terms like ‘rhabdomyolysis’ ‘RM’ and ‘antipsychotic’ were used for systematic literature research in Wanfang database, CNKI, Pubmed and Embase respectively. Data collection time ranged from 1980.1.1 to 2019.4.1.RESULTS All the 29 reported cases were absence of NMS. The suspected antipsychotic medicines for these 29 cases were olanzapine (n=7), quetiapine (n=6), risperidone (n=4), haloperidol (n=3), aripiprazole (n=2), clozapine (n=1), mitazapine (n=3), levomepromazine (n=1), loxapine(n=2). Twenty-four (83%) patients were taking two or more medicines. Symptoms of rhabdomyolysis includes muscle pain,weakness in mobility, changes in urine color. Not all patients showed such symptoms. Six cases developed AKI. There is no relationship between the onset of rhabdomyolysis and antipsychotic medicines dosages. CONCLUSION Antipsychotic drugs use is associated with an increased risk of rhabdomyolysis. It seems more common in those taking polypharmacy. Patients and caregivers should pay attention to the symptoms of muscle pain,weakness in mobility, abdominal pain, changes in urine color, especially dosage increment or starting a new medication.
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2019, Vol. 54 
