Can atypical antipsychotics cause neuroleptic malignant syndrome?

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal adverse event associated with the use of antipsychotics. Although atypical antipsychotics were initially considered to carry no risk of NMS, reports have accumulated over time implicating them in NMS causation.

What antipsychotics cause neuroleptic malignant syndrome?

The primary trigger of NMS is dopamine receptor blockade and the standard causative agent is an antipsychotic. Potent typical neuroleptics such as haloperidol, fluphenazine, chlorpromazine, trifluoperazine, and prochlorperazine have been most frequently associated with NMS and thought to confer the greatest risk.

What medications can cause neuroleptic malignant syndrome?

Atypical antipsychotic drugs that may cause NMS include the following:

  • Olanzapine.
  • Risperidone.
  • Paliperidone.
  • Aripiprazole.
  • Ziprasidone.
  • Amisulpride.
  • Quetiapine.

Is neuroleptic malignant syndrome a side effect of antipsychotics?

Neuroleptic malignant syndrome is a rare but potentially life-threatening reaction to the use of almost any of a group of antipsychotic drugs or major tranquilizers (neuroleptics).

Can antidepressants cause neuroleptic malignant syndrome?

An antidepressant-induced NMS is a very rare complication on the basis of pretreatment with neuroleptics causing chronic dopamine blockade and elevated plasma level of neuroleptics due to comedicated antidepressants.

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Which atypical antipsychotic drug has the lowest hypotensive effects?

Quetiapine and risperidone appear to have the lowest risk of hypertension.

How long does it take to recover from neuroleptic malignant syndrome?

NMS usually gets better in 1 to 2 weeks. After recovery, most people can start taking antipsychotic medicine again. Your doctor might switch you to a different drug.

How do you reverse neuroleptic malignant syndrome?

The symptoms reverse with reinstitution of therapy, and benzodiazepines may be helpful. A central anticholinergic syndrome most often associated with intended or inadvertent drug overdose is better known. Patients present with encephalopathy and elevated body temperatures that are usually not as severe as NMS.

How do you test for neuroleptic malignant syndrome?

No laboratory test result is diagnostic for neuroleptic malignant syndrome (NMS).

Approach Considerations

  1. Complete blood count (CBC)
  2. Blood cultures.
  3. Liver function tests (LFTs)
  4. Blood urea nitrogen (BUN) and creatinine levels.
  5. Calcium and phosphate levels.
  6. Creatine kinase (CK) level.
  7. Serum iron level.
  8. Urine myoglobin level.

What does it feel like to have serotonin syndrome?

Serotonin Syndrome Symptoms

Gastrointestinal symptoms include diarrhea and vomiting. Nervous system symptoms include overactive reflexes and muscle spasms, said Su. Other serotonin syndrome symptoms include high body temperature, sweating, shivering, clumsiness, tremors, and confusion and other mental changes.

When should I restart antipsychotic after NMS?

Approximately 2 weeks after resolution of NMS, treatment with a low-potency atypical antipsychotic should be initiated at a low dose and slowly titrated in a monitored setting with careful assessment for signs of recurrent NMS.

Are neuroleptics and antipsychotics the same thing?

Neuroleptics, also known as antipsychotic medications, are used to treat and manage symptoms of many psychiatric disorders. They fall into two classes: first-generation or “typical” antipsychotics, and second-generation or “atypical” antipsychotics.

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Is Abilify atypical or typical?

Aripiprazole (Abilify®) is an atypical antipsychotic drug that has been recently introduced for clinical use in the treatment of schizophrenia.

Psychoactive drugs and substances