Diagnosing subtypes of neuroleptic malignant syndrome: an introduction to the Lee-Carroll Scale.

BACKGROUND: Neuroleptic malignant syndrome (NMS) shares common features with catatonia and serotonin syndrome (SS). For instance, catatonia is a risk factor for the development of NMS. METHODS: We performed a pilot study to examine if the Lee-Carroll Scale is able to differentiate the proposed NMS subtypes and explore possible relationship between NMS and SS. A consecutive series of cases reported to the Neuroleptic Malignant Syndrome Information Service (NMSIS) were reviewed with 29 cases of "definite NMS." The Hynes-Vickar Scale (an NMS scale), Hegerl Scale (a SS scale), and Lee-Carroll Scale (an NMS subtype scale) were applied to these case report forms. CONCLUSIONS: Although the groups were too small for statistical analysis, the 2 catatonic NMS subtypes appear to have higher NMS scores on the Hynes-Vickar Scale, and lower SS scores on the Hegerl Scale than the non-catatonic NMS subtype. The scores on the Lee-Carroll Scale were highest for non-catatonic NMS subtype. This pilot study suggests that the Lee-Carroll scale may help differentiate the subtypes of NMS, and provides some support that non-catatonic NMS may be a form of SS. NMS subtypes may be important in the early detection and treatment of NMS.

Citalopram treatment of minor depression in elderly men: an open pilot study.

Antidepressant pharmacotherapy in elderly patients is challenging. The authors examined the use of citalopram to treat late-life minor depression. Ten men (mean age: 73+/-2 years) with DSM-IV Minor Depression were administered citalopram 20 mg/day. Efficacy was measured with the Geriatric Depression Scale (GDS), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impressions of Severity (CGI-S) scales. Citalopram was well tolerated, and GDS, MADRS, and CGI-S scores decreased after 12 weeks. These findings indicate that citalopram is safe and effective in the treatment of late-life minor depression.