How is neuroleptic malignant syndrome diagnosed?
Diagnosis. Your doctor will look for the two main symptoms of NMS: a high temperature and stiff muscles. To be diagnosed with it, you also need to have a few other warning signs, like a fast heartbeat, low or high blood pressure, and sweating. Some other disorders have symptoms that are similar to NMS.
How do you treat neuroleptic malignant syndrome?
Treatment of patients with neuroleptic malignant syndrome may include the following:
- Benzodiazepines for restraint may be useful.
- Stop all neuroleptics.
- Correct volume depletion and hypotension with intravenous fluids.
- Reduce hyperthermia.
What medications 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.
How long does it take to develop neuroleptic malignant syndrome?
The key to diagnosis is that NMS occurs only after exposure to an neuroleptic drug. On average, onset is 4-14 days after the start of therapy; 90% of cases occur within 10 days. However, NMS can occur years into therapy. Once the syndrome starts, it usually evolves over 24-72 hours.
What are signs and symptoms of neuroleptic malignant syndrome?
Symptoms of neuroleptic malignant syndrome usually include very high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure, …
How can you prevent neuroleptic malignant syndrome?
The most important aspect of treatment is prevention. This includes reducing risk factors (e.g. dehydration, agitation and exhaustion), early recognition of suspected cases and prompt discontinuation of the offending agent.
Which medication is associated with the highest risk of tardive dyskinesia?
Taking neuroleptics, especially over an extended period, is the biggest risk factor for developing tardive dyskinesia.
Why is NMS a medical emergency?
Neuroleptic malignant syndrome (NMS) is a lethal medical emergency associated with the use of neuroleptic agents and antiemetics that is characterized by a typical clinical syndrome of hyperthermia, rigidity, mental status alteration, and dysautonomia.
Does dantrolene need to be tapered?
It is important that the dosage be titrated and individualized for maximum effect. The lowest dose compatible with optimal response is recommended. In view of the potential for liver damage in long-term Dantrolene sodium capsule use, therapy should be stopped if benefits are not evident within 45 days.
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.
What is the difference between neuroleptic malignant syndrome and serotonin syndrome?
NMS and serotonin syndrome are rare, but potentially life-threatening, medicine-induced disorders. Features of these syndromes may overlap making diagnosis difficult. However, NMS is characterised by ‘lead-pipe’ rigidity, whilst serotonin syndrome is characterised by hyperreflexia and clonus.