neuroleptic malignant syndrome

what is neuroleptic malignant syndrome?

rare but very serious condition seen in patients taking an antipsychotic medication

what other drugs can cause neuroleptic malignant syndrome?

dopaminergic drugs - e.g. levodopa when they are stopped or the dose is reduced

when does NMS occur in terms of starting an antispychotic?

hours to days after starting

what are the clinical features of NMS?

- pyrexia

- muscle rigidity

- autonomic lability

- agitated delirium

- confusion

what are the features of autonomic lability?

- hypertension

- tachycardia

- tachypnoea

what is a key feature on blood tests?

raised CK from rhabdomyolysis

what can then occur?

AKI

what is the management of NMS?

- stop antipsychotic

- admitted to medical ward or ICU

- IV fluids to prevent renal failure

what drugs may be used in NMS?

- dantrolene

- bromocriptine

- dopamine agonists

what is the difference between NMS and serotonin syndrome?

SS - usually has a faster onset (hours) and does not last as long

SS - hyperreflexia

NMS - hyporeflexia