{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:13:45Z","timestamp":1777432425040,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2016,7,10]],"date-time":"2016-07-10T00:00:00Z","timestamp":1468108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Australas Psychiatry"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Clozapine is the gold-standard antipsychotic medication for treatment-refractory schizophrenia (TRS). However, one potentially lethal side effect of clozapine, as with other antipsychotics, is neuroleptic malignant syndrome (NMS) which could present differently in clozapine therapy. \u2018Atypical NMS\u2019 is a recognised variant of NMS with less rigidity and delayed elevation of creatine kinase; this variant is associated with clozapine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>A case from the author\u2019s clinical practice was reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 67-year-old man with TRS was treated with clozapine. Unfortunately, his physical condition deteriorated and he presented with atypical NMS, which initially was treated as presumable urinary tract infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Atypical NMS is associated with clozapine. This case exposes the potential difficulties in diagnosis, and highlights the importance of considering less common diagnoses in acutely unwell psychiatric patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1039856216649768","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T22:24:29Z","timestamp":1463610269000},"page":"602-603","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Fever, confusion, acute kidney injury: is this atypical neuroleptic malignant syndrome following polypharmacy with clozapine and risperidone?"],"prefix":"10.1177","volume":"24","author":[{"given":"Scott","family":"Cherry","sequence":"first","affiliation":[{"name":"Consultant Psychiatrist, Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Siskind","sequence":"additional","affiliation":[{"name":"Clinical Academic Psychiatrist, Metro South Addiction and Mental Health Services, Brisbane, QLD, and; Associate Professor, University of Queensland School of Medicine, Woolloongabba, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Spivak","sequence":"additional","affiliation":[{"name":"Psychiatry Registrar, Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Wysoczanski","sequence":"additional","affiliation":[{"name":"Psychiatry Registrar, Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyangika","family":"Halangoda","sequence":"additional","affiliation":[{"name":"Psychiatry Registrar, Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,10]]},"reference":[{"key":"bibr1-1039856216649768","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/j.1440-1614.2005.01516.x","volume":"35","author":"Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for the Treatment of Schizophrenia and Related Disorders","year":"2005","journal-title":"Aust N Z J Psychiatry"},{"key":"bibr2-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2007.164.6.870"},{"key":"bibr3-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23220"},{"key":"bibr4-1039856216649768","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-19910301-10"},{"key":"bibr5-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.105189"},{"key":"bibr6-1039856216649768","first-page":"36","volume":"2","author":"Caroff SN.","year":"2003","journal-title":"Curr Psychiatry"},{"key":"bibr7-1039856216649768","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-20000501-09"},{"key":"bibr8-1039856216649768","volume":"150","author":"Patterson BD","year":"1993","journal-title":"Am J Psychiatry"},{"key":"bibr9-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199304000-00013"},{"key":"bibr10-1039856216649768","volume":"152","author":"Nitenson NC","year":"1995","journal-title":"Am J Psychiatry"},{"key":"bibr11-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979495"},{"key":"bibr12-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1985.tb01268.x"},{"key":"bibr13-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1094343"},{"key":"bibr14-1039856216649768","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n1005"},{"key":"bibr15-1039856216649768","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12222"}],"container-title":["Australasian Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1039856216649768","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1039856216649768","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1039856216649768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:48:25Z","timestamp":1777376905000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1039856216649768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,10]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1177\/1039856216649768"],"URL":"https:\/\/doi.org\/10.1177\/1039856216649768","relation":{},"ISSN":["1039-8562","1440-1665"],"issn-type":[{"value":"1039-8562","type":"print"},{"value":"1440-1665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,10]]}}}