Life-threatening conditions in psychiatry – neuroleptic malignant syndrome (NMS)
Journal Title: Journal of Pre-Clinical and Clinical Research - Year 2015, Vol 9, Issue 1
Abstract
The introduction of neuroleptics in the 1950’s was a turning point in psychiatric treatment. The new drugs brought hope to millions of patients and their doctors. However, there were also some side-effects, one of which is Neuroleptic malignant syndrome (NMS), a rare complication of antipsychotic treatment and untreated it may lead to mortality as high as 20%. The incidence of NMS, estimated to be 0.01–0.02%, has decreased significantly probably due to higher awareness of the diseases and shift to atypical antipsychotics. The aim of this study was to present the signs and symptoms of this rare condition and describe management possibilities since this condition is observed not only in psychiatric departments but also in emergency rooms. NMS is thought to be related to change caused by neuroleptics within the central nervous system due to dopamine D2 receptor antagonism, especially nigrostriatal pathways and the hypothalamus. There are three symptoms which are considered as major and indicate a high probability of NMS: muscle rigidity, hyperthermia (core body temperature above 38.5 °C), and elevated creatine phosphokinase concentration (above 1000 U/l). NMS is a diagnosis of exclusion and clinicians must be vigilant in detecting early signs of NMS. The basic management in NMS is antipsychotic discontinuation and proper supportive care of the patient (vital signs monitoring, hydration, correction of electrolyte and acid-base disturbances). In more severe cases, the introduction of bromocriptine or dantrolene, as well as benzodiazepines, may indicated. Further usage of neuroleptic in patients with a history of NMS should be with care, and low doses of low-potency neuroleptics or atypical neuroleptics seem to be the best treatment choice.
Authors and Affiliations
Tomasz Kucmin, Adriana Kucmin, Małgorzata Płowaś-Goral, Mariusz Jojczuk
Keywords
Related Articles
- EP ID EP58550
- DOI -
- Views 108
- Downloads 0
Epidemiological assessment of maxillofacial fractures in inhibitants of Lower Silesia, Poland, in 2002–2006 – Treatment of maxillofacial fracture
[b]Introduction and objective[/b]. Epidemiological assessment of maxillofacial fractures carried out by a given specialized centre may constitute valuable material for comparison with other regions of Poland and the Euro...
Quercetin: health benefits with relevance to TNF-α-linked inflammatory diseases
With increasing interest among the general public for using natural and herbal remedies, there is a great need to document and list ancient medical texts and practices, as well as to investigate the efficacy of a number...
Differences in diazepam influence on the behaviour of rabbits under spontaneous conditions, and after electrical stimulation of the ventromedial hypothalamic nucleus
The purpose of the present study was to compare the influence of diazepam on different forms of rabbits’ behaviour under stress and spontaneodial hypothalamic nucleus, escape reactionus conditions. The experimental mode...
Autoimmunity markers in subjects with diabetes
[b]Introduction.[/b] Diabetes is a growing social and epidemiological problem. Accordingly, the incidence of complications associated with diabetes can cause a persistent high percentage of diseases of the cardiovascular...
Analysis of the impact of education level on the sense of coherence and opinion concerning carrying out preventive vaccination
[b]Introduction[/b]. Nowadays, preventive vaccination is still the most effective method of countering and combating infectious diseases. Objective. The objective of the present study was to take into consideration the...