Neuroleptic malignant syndrome in patients with cancer: a systematic review.

Abstract

BACKGROUND:

Antipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist.

AIMS:

We aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer.

METHODS:

We conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS.

RESULTS:

Eleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32-83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary.

CONCLUSION:

Although NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.

• Authors: Izumi Sato, Hideki Onishi, Chiaki Kawanishi, Shuhei Yamada, Mayumi Ishida, Koji Kawakami
• Journal: BMJ supportive & palliative care (BMJ Support Palliat Care) Vol. 10 Issue 3 Pg. 265-270 (Sep 2020) ISSN: 2045-4368 [Electronic] England
• PMID: 32414787 (Publication Type: Journal Article, Systematic Review)
• Copyright: © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Antipsychotic Agents
• Dopamine D2 Receptor Antagonists
• Dantrolene
• Haloperidol

Topics

• Adult
• Aged
• Aged, 80 and over
• Antipsychotic Agents (adverse effects)
• Dantrolene (therapeutic use)
• Dopamine D2 Receptor Antagonists (adverse effects)
• Female
• Haloperidol (adverse effects)
• Humans
• Male
• Middle Aged
• Neoplasms (complications)
• Neuroleptic Malignant Syndrome (drug therapy, etiology, mortality)