[Neuroleptic malignant syndrome: predisposing factors, symptomatoly, treatments and complications]

ABSTRACT

Neuroleptic Malignant Syndrome [NMS] is an acute and dangerous syndrome which usually arise as a side-effect of Neuroleptic drugs. Its high mortality rate, acute course and the current controversies about the best treatment method indicates the necessity of further investigation on its clinical features, predisposing factors and effective therapeutic methods. Retrospectively in a 4-year period, we studied patients hospitalized with NMS applying a 7-section questionnaire assessing drug historys, the underlying psychiatric disorder, clinical signs and symptoms, laboratory findings, treatment methods and their outcomes, and duration of hospital stay. Rigidity and impaired consciousness were the most common clinical findings. Haloperidol, perphenazine and risperidone were the most common antisychotics used before the NMS onset. Mood disorders, schizophrenia, and mental retardation were the most frequent underlying disorders. The most common prescriptions for treatment of NMS were bromocriptine, fluid and electrolytes therapy, and amantadine. In diagnosing the NMS, impaired consciousness, especially when being accompanied by rigidity and fever, may be a more sensitive criteria than it is currently believed. Bromocriptin and fluid and electrolyte replacement therapy among many other treatment methods, and also interventions for prevention of NMS complications may play important roles in reducing its mortality rate