What is Neuroleptic Malignant Syndrome?

This is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. It is the most serious and represents a neurologic emergency in most cases. It has now been reported to occur with all drugs that effect the central dopaminergic system.

Causes of Neuroleptic Malignant Syndrome:

Following drugs, medications, substances or toxins are some of the most possible causes of this disorder. This list is incomplete and many other drugs or substances may causes of Neuroleptic Malignant Syndrome:
• Neuroleptic drugs,antipsychotic drugs
• Dopaminergics (anti-Parkinsonism drugs)
• Chlorpromazine Hydrochloride
• Ormazine
• Chlorprothixine

Symptoms of Neuroleptic Malignant Syndrome:

The most symptoms of this disorder are like high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction. In most cases, the disorder develops within the first 2 weeks of treatment with the drug, however, the disorder may develop any time during the therapy period.

Diagnosis of Neuroleptic Malignant Syndrome:

The diagnostic criteria for neuroleptic malignant syndrome includes the presence of hyperthermia (temperature over 38° C or 101° F) with no other assignable cause, muscle rigidity, and at least five of the following signs or symptoms: Impaired mental status, fast heart rate, fast respiratory rate, fluctuating blood pressure, metabolic acidosis, excess blood acidity, increased blood levels of creatanine phosphokinase (normally found in muscles and released into the bloodstream due to muscle damage), drooling, or increased white blood cell counting.

Treatment of Neuroleptic Malignant Syndrome:

Supportive treatment should include cooling, hydration with fluids and supple-mental oxygen. Causative medications should be immediately discontinued, and medications that restore dopamine levels (bromocriptine, amantadine) administered. Dantrolene can be given to more quickly resolve muscle rigidity and hyperthermia. Benzodiazepines (such as lorazepam) may help agitated patients, and may also help relax rigid muscles.