Síndrome anticolinérgico por biperideno, un complejo diagnóstico diferencial. A propósito de un caso

Abstract

Various pharmacological groups can trigger a series of acute dysautonomias that have the following features in common: muscle rigidity, hyperthermia, and autonomic dysfunction.

All these dysautonomias are grouped within the so-called drug-induced hyperthermic syndromes. They are characterized by a hypermetabolic state secondary to taking medications and other agents that alter neurotransmitter levels. Three of these syndromes: neuroleptic malignant syndrome, serotonin syndrome and anticholinergic syndrome are of special relevance in the psychiatric field since they are associated with the taking of drugs widely used by their specialists.

All of them have high morbidity and mortality, which is why they require a multidisciplinary approach to guarantee adequate diagnosis and therapeutic management.

For all these reasons, we present the case of a 49-year-old woman admitted to the Mental Health Hospitalization Unit as a result of catatonic symptoms who, on the third day of admission, developed symptoms of dysautonomia and hyperthermia concomitant with taking Olanzapine, citalopram and biperiden reason for which a complex differential diagnosis is proposed between: NMS, SS vs. AS.