Neuroleptic Malignant Syndrome

A potentially fatal syndrome associated primarily with the use of neuroleptic agents (see ANTIPSYCHOTIC AGENTS) which are in turn associated with dopaminergic receptor blockade (see RECEPTORS, DOPAMINE) in the BASAL GANGLIA and HYPOTHALAMUS, and sympathetic dysregulation. Clinical features include diffuse MUSCLE RIGIDITY; TREMOR; high FEVER; diaphoresis; labile blood pressure; cognitive dysfunction; and autonomic disturbances. Serum CPK level elevation and a leukocytosis may also be present. (From Adams et al., Principles of Neurology, 6th ed, p1199; Psychiatr Serv 1998 Sep;49(9):1163-72)

Also Known As:

Networked: 801 relevant articles (24 outcomes, 9 trials/studies) for this Disease, Comments

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Fever (Fevers)
2.	Malignant Hyperthermia
3.	Parkinson Disease (Parkinson's Disease)
4.	Dyskinesias (Dyskinesia)
5.	Muscle Rigidity

Experts

1.	Kawanishi, Chiaki: 7 articles (11/2007 - 01/2003)
2.	Kishida, Ikuko: 5 articles (11/2007 - 03/2003)
3.	Kato, Daiji: 5 articles (11/2007 - 03/2005)
4.	Hirayasu, Yoshio: 5 articles (11/2007 - 03/2005)
5.	Caroff, Stanley N: 4 articles (04/2007 - 11/2002)
6.	Duggal, Harpreet S: 4 articles (01/2007 - 01/2004)
7.	Matsumura, Takehiko: 4 articles (10/2006 - 03/2003)
8.	Bourgeois, James A: 4 articles (02/2006 - 01/2002)
9.	Tanii, Hisashi: 3 articles (01/2010 - 03/2006)
10.	Strawn, Jeffrey R: 3 articles (04/2008 - 04/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Neuroleptic Malignant Syndrome:

1.	Dantrolene (Dantrium)FDA LinkGeneric 02/01/2010 - "She received infusion of 140 mg dantrolene in total under suspicion of having neuroleptic malignant syndrome, but her symptoms improved slightly. " 05/01/1998 - "Efficacy of prolonged large-dose dantrolene for severe neuroleptic malignant syndrome." 09/01/2003 - "The patient was diagnosed as neuroleptic malignant syndrome and given medication dantrolene sodium and antiparkinsonian drugs on the 5th postoperative day. " 09/01/2003 - "Neuroleptic malignant syndrome following cardiac surgery: successful treatment with dantrolene." 03/01/2003 - "In addition to its use for MH, dantrolene is used in other disorders such as neuroleptic malignant syndrome and spasticity. " Order ALL the reference details at left...
2.	Bromocriptine (Parlodel)FDA LinkGeneric 02/01/1986 - "This constellation of symptoms, known as the neuroleptic malignant syndrome (NMS), partially improved when the neuroleptic medication was stopped, but complete resolution of the syndrome did not occur until the patient was treated with bromocriptine. " 04/01/1991 - "Neuroleptic malignant syndrome improved by bromocriptine." 05/01/1990 - "Neuroleptic malignant syndrome improved by bromocriptine." 03/01/1996 - "Bromocriptine (BROMO), which is used for the treatment of neuroleptic malignant syndrome, also decreased NK cell activity. " 10/01/1995 - "With regards to the neuroleptic malignant syndrome dantrolenum and bromocriptin treatment were applied with the discontinuation of neuroleptic medication. " Order ALL the reference details at left...
3.	Antipsychotic Agents (Antipsychotics)IBA 01/01/2007 - "BACKGROUND: This case series study examines the hypothesis that neuroleptic malignant syndrome (NMS) is a heterogeneous condition including catatonic variants and non-catatonic pathological reactions to antipsychotics. " 01/01/2010 - "Although the relationship between antipsychotic medication, particularly second-generation antipsychotics (SGAs), and metabolic disturbance is increasingly accepted, there is an important, but little recognised, potential interaction between this and the other important serious adverse effect of neuroleptic malignant syndrome (NMS). " 10/01/2009 - "Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency that may be caused by neuroleptic agents of any class. " 07/01/2009 - "Although diagnostic criteria for neuroleptic malignant syndrome have been established and are widely accepted and used, it should be recognized that atypical presentations occur, particularly during treatment with atypical antipsychotics. " 01/01/2009 - "The prevalence of neuroleptic malignant syndrome is between 0.02% and 2.44% for patients taking neuroleptics and it is not necessary to fulfil all cardinal features characterizing the syndrome to be diagnosed with neuroleptic malignant syndrome. " Order ALL the reference details at left...
4.	Haloperidol (Haldol)FDA LinkGeneric 10/01/2009 - "Haloperidol-induced neuroleptic malignant syndrome complicated by hyperosmolar hyperglycemic state." 03/01/2007 - "The patient's presenting signs and symptoms were not typical of the disease; however, PSP most likely played a role in the neuroleptic malignant syndrome-like manifestations the patient exhibited following the Haldol administration. " 12/01/2006 - "Described in 1960 by Jean Delay in relation to the use of haloperidol, neuroleptic malignant syndrome remains relatively rare, and poorly known by the medical profession. " 02/01/2002 - "Assessment of the neuroleptic malignant syndrome was carried out by using the Naranjo Algorithm Probability Scale which resulted in a highly probable reaction to haloperidol. " 04/01/2001 - "Neuroleptic malignant syndrome after addition of haloperidol to atypical antipsychotic." Order ALL the reference details at left...
5.	Clozapine (Clozaril)FDA LinkGeneric 12/01/2007 - "Atypical neuroleptic malignant syndrome with long-term clozapine." 02/01/2006 - "[Neuroleptic malignant syndrome after 30 years treatment with clozapine: a rarely seen differential diagnosis on intensive care units]" 01/01/2005 - "Neuroleptic malignant syndrome and clozapine withdrawal at the same time?" 09/03/2002 - "Clozapine-associated neuroleptic malignant syndrome." 08/01/2001 - "Clozapine has recently been found to be associated with neuroleptic malignant syndrome (NMS) after long-term treatment. " Order ALL the reference details at left...
6.	LithiumIBA 07/01/1991 - "Lithium toxicity--a risk factor for neuroleptic malignant syndrome." 10/01/1987 - "Neuroleptic malignant syndrome or lithium neurotoxicity?" 10/01/1987 - "Both patients rapidly developed recurrent neuroleptic malignant syndrome after only 300 and 1,200 mg of lithium, respectively. " 10/01/1987 - "Reinduction of neuroleptic malignant syndrome by lithium." 04/01/1987 - "Neuroleptic malignant syndrome or lithium neurotoxicity." Order ALL the reference details at left...
7.	Diazepam (Valium)FDA LinkGeneric 10/01/1995 - "He developed neuroleptic malignant syndrome (NMS) which was treated successfully with intravenous diazepam. " 06/01/1997 - "Diazepam-responsive neuroleptic malignant syndrome: a diagnostic subtype?" 11/01/1988 - "Neuroleptic malignant syndrome treated with Diazepam." 09/01/1988 - "A mild form of neuroleptic malignant syndrome (NMS) in a schizophrenic patient who was receiving a depot neuroleptic is described and beneficial response to oral diazepam 50 mg daily is reported." 09/01/1988 - "Treatment of a mild form of neuroleptic malignant syndrome with oral diazepam." Order ALL the reference details at left...
8.	MethylprednisoloneFDA LinkGeneric 03/01/2007 - "Methylprednisolone pulse therapy also is beneficial for neuroleptic malignant syndrome due to abrupt medication withdrawal in patients with Parkinson's disease. " 05/01/2003 - "Efficacy of methylprednisolone pulse therapy on neuroleptic malignant syndrome in Parkinson's disease." Order ALL the reference details at left...
9.	Risperidone (Risperdal Consta)FDA LinkGeneric 05/01/2009 - "DISCUSSION: We postulate a possible interaction between risperidone and neuroleptic malignant syndrome and we suggest to use risperidone with caution in both young and middle aged people." 05/01/2009 - "A case of neuroleptic malignant syndrome induced by risperidone in a schizophrenic woman." 03/01/2009 - "This report describes a case of neuroleptic malignant syndrome due to risperidone in a child with Joubert syndrome." 03/01/2009 - "Neuroleptic malignant syndrome due to risperidone treatment in a child with Joubert syndrome." 07/01/2008 - "A Case of neuroleptic malignant syndrome accompanied to an atypical antipsychotic agent: risperidone." Order ALL the reference details at left...
10.	Levodopa (L Dopa)FDA LinkGeneric 05/01/2009 - "Neuroleptic malignant syndrome without withdrawal of levodopa." 01/01/2003 - "Neuroleptic malignant syndrome-like, or--dopaminergic malignant syndrome--due to levodopa therapy withdrawal. " 12/01/1995 - "Neuroleptic malignant syndrome postoperative onset due to levodopa withdrawal." 03/01/1992 - "We report a case of neuroleptic malignant syndrome (NMS) following abrupt reduction of chronic levodopa treatment in a 71 year old female parkinsonian patient. " 07/01/1991 - "Neuroleptic malignant syndrome complicating levodopa withdrawal." Order ALL the reference details at left...

Therapies and Procedures

1.	Intramuscular Injections 10/01/1989 - "Patients with neuroleptic malignant syndrome displayed significantly greater psychomotor agitation, received significantly higher doses of neuroleptics at greater rates of dosage increase, and received a greater number of intramuscular injections than controls." 11/01/1998 - "The files of 183 hospitalized children and adolescents (93 boys, 90 girls) with severe psychiatric disorders were reviewed for serum creatine kinase activity on admission, psychomotor agitation, Clinical Global Impression Score, need for intramuscular injection, number of neuroleptic medications and presence of neuroleptic malignant syndrome. " Order ALL the reference details at left...
2.	Intravenous Injections 04/15/1997 - "Intravenous injection of levodopa is more effective than dantrolene as therapy for neuroleptic malignant syndrome." Order ALL the reference details at left...
3.	Induced Hyperthermia (Thermotherapy) 11/01/1995 - "OBJECTIVE: Neuroleptic Malignant Syndrome (NMS) is a rare but potentially lethal form of drug-induced hyperthermia. " 04/01/2004 - "We describe four cases with advanced stage Huntington's disease who within a period of one year developed drug-induced hyperthermia, either the neuroleptic malignant syndrome, or the serotonin syndrome. " 01/01/2002 - "The neuroleptic malignant syndrome (NMS) is a rare but potentially lethal form of neuroleptic drug-induced hyperthermia, altered level of consciousness, extrapyramidal effects, autonomic instability and muscle rigidity. " 07/01/1998 - "Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal form of drug-induced hyperthermia characterised by mental status changes, muscle rigidity, hyperthermia and autonomic dysfunction. " 10/01/1997 - "This article reviews the pathophysiology, presentation, and treatment of several drug-induced hyperthermia syndromes: malignant hyperthermia, neuroleptic malignant syndrome, sympathomimetic poisoning, and anticholinergic toxicity. " Order ALL the reference details at left...
4.	Injections 03/13/1995 - "Changes are that D2 receptors in the human LH could be responsible for the neuroleptic malignant syndrome (NMS), and that sulpiride injections in the rat LH could be used as a model for the study of the pathogenesis of this syndrome." 10/01/2008 - "Catatonia and mild neuroleptic malignant syndrome after initiation of long-acting injectable risperidone: case report." Order ALL the reference details at left...
5.	Drug Therapy (Chemotherapy) 11/01/2001 - "BACKGROUND: Neuroleptic malignant syndrome can be a serious neurologic complication of drug therapy during pregnancy. " 06/01/1995 - "The neuroleptic malignant syndrome (NMS) is a potentially fatal complication of antipsychotic pharmacotherapy. " 11/01/1988 - "Neuroleptic malignant syndrome is an uncommon, occasionally lethal reaction to drug therapy. " 01/01/1986 - "The neuroleptic malignant syndrome (NMS) is an under-recognized yet sometimes fatal complication of antipsychotic drug therapy. " 06/01/1988 - "Neuroleptic malignant syndrome is a complication of neuroleptic drug therapy; skeletal muscle hypertonicity helps distinguish this entity from heat stroke. " Order ALL the reference details at left...