Abstract
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially serious idiosyncratic response to neuroleptic antipsychotics. It usually affects young males, but the risk has been seen to increase with certain factors including the administration practices of antipsychotic neuroleptics in these individuals. Even though no predictors for NMS are yet known, this article highlights the findings on certain risk factors as seen from a series of fifteen patients who developed NMS. Cautious use of neuroleptics in those at risk, early recognition and institution of immediate management is important.
Keywords: neuroleptic, malignant syndrome, risk factors
Full Text
The Full Text of this article is available as a PDF (308.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Addonizio G., Susman V. L., Roth S. D. Symptoms of neuroleptic malignant syndrome in 82 consecutive inpatients. Am J Psychiatry. 1986 Dec;143(12):1587–1590. doi: 10.1176/ajp.143.12.1587. [DOI] [PubMed] [Google Scholar]
- Berardi D., Amore M., Keck P. E., Jr, Troia M., Dell'Atti M. Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: a case-control study. Biol Psychiatry. 1998 Oct 15;44(8):748–754. doi: 10.1016/s0006-3223(97)00530-1. [DOI] [PubMed] [Google Scholar]
- Caroff S. N., Mann S. C. Neuroleptic malignant syndrome. Med Clin North Am. 1993 Jan;77(1):185–202. doi: 10.1016/s0025-7125(16)30278-4. [DOI] [PubMed] [Google Scholar]
- Ebadi M., Pfeiffer R. F., Murrin L. C. Pathogenesis and treatment of neuroleptic malignant syndrome. Gen Pharmacol. 1990;21(4):367–386. doi: 10.1016/0306-3623(90)90685-f. [DOI] [PubMed] [Google Scholar]
- Gelenberg A. J., Bellinghausen B., Wojcik J. D., Falk W. E., Sachs G. S. A prospective survey of neuroleptic malignant syndrome in a short-term psychiatric hospital. Am J Psychiatry. 1988 Apr;145(4):517–518. doi: 10.1176/ajp.145.4.517. [DOI] [PubMed] [Google Scholar]
- Gleason P. P., Conigliaro R. L. Neuroleptic malignant syndrome with risperidone. Pharmacotherapy. 1997 May-Jun;17(3):617–621. [PubMed] [Google Scholar]
- Gurrera R. J. Sympathoadrenal hyperactivity and the etiology of neuroleptic malignant syndrome. Am J Psychiatry. 1999 Feb;156(2):169–180. doi: 10.1176/ajp.156.2.169. [DOI] [PubMed] [Google Scholar]
- Harsch H. H. Neuroleptic malignant syndrome: physiological and laboratory findings in a series of nine cases. J Clin Psychiatry. 1987 Aug;48(8):328–333. [PubMed] [Google Scholar]
- Hasan S., Buckley P. Novel antipsychotics and the neuroleptic malignant syndrome: a review and critique. Am J Psychiatry. 1998 Aug;155(8):1113–1116. doi: 10.1176/ajp.155.8.1113. [DOI] [PubMed] [Google Scholar]
- Heiman-Patterson T. D. Neuroleptic malignant syndrome and malignant hyperthermia. Important issues for the medical consultant. Med Clin North Am. 1993 Mar;77(2):477–492. doi: 10.1016/s0025-7125(16)30265-6. [DOI] [PubMed] [Google Scholar]
- Hermesh H., Aizenberg D., Weizman A., Lapidot M., Mayor C., Munitz H. Risk for definite neuroleptic malignant syndrome. A prospective study in 223 consecutive in-patients. Br J Psychiatry. 1992 Aug;161:254–257. doi: 10.1192/bjp.161.2.254. [DOI] [PubMed] [Google Scholar]
- Itoh H., Ohtsuka N., Ogita K., Yagi G., Miura S., Koga Y. Malignant neuroleptic syndrome--its present status in Japan and clinical problems. Folia Psychiatr Neurol Jpn. 1977;31(4):559–576. [PubMed] [Google Scholar]
- Iwahashi K. CYP2D6 genotype and possible susceptibility to the neuroleptic malignant syndrome. Biol Psychiatry. 1994 Dec 1;36(11):781–782. doi: 10.1016/0006-3223(94)90094-9. [DOI] [PubMed] [Google Scholar]
- Keck P. E., Jr, Pope H. G., Jr, Cohen B. M., McElroy S. L., Nierenberg A. A. Risk factors for neuroleptic malignant syndrome. A case-control study. Arch Gen Psychiatry. 1989 Oct;46(10):914–918. doi: 10.1001/archpsyc.1989.01810100056011. [DOI] [PubMed] [Google Scholar]
- Keck P. E., Jr, Sebastianelli J., Pope H. G., Jr, McElroy S. L. Frequency and presentation of neuroleptic malignant syndrome in a state psychiatric hospital. J Clin Psychiatry. 1989 Sep;50(9):352–355. [PubMed] [Google Scholar]
- Levenson J. L. Neuroleptic malignant syndrome. Am J Psychiatry. 1985 Oct;142(10):1137–1145. doi: 10.1176/ajp.142.10.1137. [DOI] [PubMed] [Google Scholar]
- Modestin J., Toffler G., Drescher J. P. Neuroleptic malignant syndrome: results of a prospective study. Psychiatry Res. 1992 Dec;44(3):251–256. doi: 10.1016/0165-1781(92)90028-2. [DOI] [PubMed] [Google Scholar]
- Ram A., Cao Q., Keck P. E., Jr, Pope H. G., Jr, Otani K., Addonizio G., McElroy S. L., Kaneko S., Redlichova M., Gershon E. S. Structural change in dopamine D2 receptor gene in a patient with neuroleptic malignant syndrome. Am J Med Genet. 1995 Jun 19;60(3):228–230. doi: 10.1002/ajmg.1320600311. [DOI] [PubMed] [Google Scholar]
- Reddig S., Minnema A. M., Tandon R. Neuroleptic malignant syndrome and clozapine. Ann Clin Psychiatry. 1993 Mar;5(1):25–27. doi: 10.3109/10401239309148920. [DOI] [PubMed] [Google Scholar]
- Rosebush P., Stewart T. A prospective analysis of 24 episodes of neuroleptic malignant syndrome. Am J Psychiatry. 1989 Jun;146(6):717–725. doi: 10.1176/ajp.146.6.717. [DOI] [PubMed] [Google Scholar]
- Sachdev P., Kruk J., Kneebone M., Kissane D. Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. J Clin Psychopharmacol. 1995 Oct;15(5):365–371. doi: 10.1097/00004714-199510000-00010. [DOI] [PubMed] [Google Scholar]
- Shalev A., Hermesh H., Munitz H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry. 1989 Jan;50(1):18–25. [PubMed] [Google Scholar]
- Spivak B., Weizman A., Wolovick L., Hermesh H., Tyano S., Munitz H. Neuroleptic malignant syndrome during abrupt reduction of neuroleptic treatment. Acta Psychiatr Scand. 1990 Feb;81(2):168–169. doi: 10.1111/j.1600-0447.1990.tb06473.x. [DOI] [PubMed] [Google Scholar]
- Velamoor V. R., Norman R. M., Caroff S. N., Mann S. C., Sullivan K. A., Antelo R. E. Progression of symptoms in neuroleptic malignant syndrome. J Nerv Ment Dis. 1994 Mar;182(3):168–173. doi: 10.1097/00005053-199403000-00007. [DOI] [PubMed] [Google Scholar]