In neuroleptic malignant syndrome

Viejo LF, Morales V Punal P, et al. Risk factors in neuroleptic malignant syndrome. A case-control study. 

Dantrolene may be effective in reducing muscle rigidity in neuroleptic malignant syndrome (388,389) (SEDA-20, 42), but a reliable regimen has not been established (390). 

Black KJ, Racette B, Perlmutter JS. Preventing contractions in neuroleptic malignant syndrome and dystonia. Am J Psychiatry 1998 155(9) 1298-9. 

An overdose of oral risperidone in a cliild resulted in neuroleptic malignant syndrome [255 ]. A case of neuroleptic malignant syndrome in a 50-year-old male treated with levopromazine and risperidone microspheres (14 weeks after first injection and 1 week after the last injection) is reported [256 ]. A case of neuroleptic malignant syndrome during pregnancy is reported [257 ]. 

Other sedative-hypnotic medications, such as barbiturates, may play a useful role in severe withdrawal from this group of drugs. For example, in a case series of GBL withdrawal, use of intravenous pentobarbital in the range of 1-2 mg/kg/hour lowered the total requirement for intravenous lorazepam (Sivilotti et al. 2001). Antipsychotic medications are often used to reduce psychotic agitation. However, because antipsychotic medications lower the seizure threshold and may contribute to loss of central control of temperature leading to hyperthermia or neuroleptic malignant syndrome (NMS), they are not indicated as first-line medications for GHB withdrawal delirium (Dyer and Roth 2001 McDaniel and Miotto 2001 Sharma et al. 2001). If anti-... 

The patient may be alert and oriented, withdrawn or lethargic, or have an acute brain syndrome. There is a high incidence of rhabdomyolysis and hyperthermia in PCP-induced catatonic syndrome. Some patients have the neuroleptic malignant syndrome or develop it after administration of haloperidol. 

Kosten, T. and Kleber, H.D. Sudden death in cocaine abusers relation to neuroleptic malignant syndrome. Lancet. 1 1198, 1987. 

Neuroleptic malignant syndrome is an acute iatrogenic condition caused by neuroleptics, characterized by tremor, catatonia, fluctuating consciousness, hyperthermia, and cardiovascular instability. It is relatively uncommon, occuring in 1-1.5% of patients but is fatal in 11-38%, most often due to cardiovascular collapse (Jahan et al. 1992). The pathogenesis of neuroleptic malignant syndrome is poorly understood, but it is believed to result from altered dopamine and serotonin transmission in the hypothalamus, spinal cord, and striatum. Treatment includes discontinuation of neuroleptics and administration of drugs that increase dopamine transmission bromocriptine or L-dopa (Jahan etal. 1992 Baldessarini 1996). 

Neuroleptic malignant syndrome (NMS) A potentially fatal symptom complex sometimes referred to as NMS has been reported in association with promethazine alone or in combination with antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (eg, irregular pulse or blood pressure, tachycardia, diaphoresis, cardiac dysrhythmias). 

Neuroleptic malignant syndrome (NMS) NMS is a potentially fatal condition reported in association with antipsychotic drugs and with amoxapine. 

Tapering of dose Cases of a symptom complex resembling neuroleptic malignant syndrome characterized by elevated temperature, muscular rigidity, altered consciousness, and elevated creatine phosphokinase (CPK) have been reported in association with the rapid dose reduction or withdrawal of other dopaminergic drugs. 

Neuroleptic malignant syndrome (NMS) Sporadic cases of possible NMS have been reported in association with dose reduction or withdrawal of amantadine therapy. Observe patients carefully when the dosage of amantadine is reduced abruptly or discontinued, especially if the patient is receiving neuroleptics. 

Combined with levodopa and a decarboxylase inhibitor more stable levodopa levels can be obtained. Tolcapon has been withdrawn in many countries because of serious liverfunction disturbances, rhab-domyolysis and neuroleptic malignant syndrome. 

Which drug may be useful in the management of the neuroleptic malignant syndrome, although it can worsen the symptoms of schizophrenia ... 

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