YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==NEUROLEPTIC MALIGNANT SYNDROME== 2 AUTHOR Akpaffiong MJ TITLE Risk factors for neuroleptic malignant syndrome. SOURCE J Natl Med Assoc 1992 Sep;84(9):800-2 ABSTRACT Neuroleptic malignant syndrome, a rare and potentially fatal complication of antipsychotic drugs, is poorly understood. Equally poorly understood are the risk factors of neuroleptic malignant syndrome. Long-term and parenteral treatment with high doses of neuroleptic drugs are implicated as risk factors for the syndrome. Recently, attention has been drawn to the frequency of neuroleptic malignant syndrome in patients treated with a combination of haloperidol and lithium. This article reports a case in which the patient's risk factors for neuroleptic malignant syndrome included not only haloperidol and lithium but also a predisposition to substances of abuse. 3 AUTHOR Wolf MA AUTHOR Villeneuve A TITLE [Side-effects of neuroleptics] SOURCE Encephale 1990 Mar-Apr;16(2):111-24 ABSTRACT Due to their pharmacological activity on various receptors, particularly dopaminergic, cholinergic and adrenergic ones, neuroleptics induce various side effects, central as well as peripheric. These side effects are of various nature: psychic and cognitive, neurologic affecting mostly the extrapyramidal system, neuroendocrinian and metabolic, as well as neurovegetative. Toxic manifestations, hepatic, hematologic and others, have been associated with their use, as well as a malignant syndrome that can be lethal. They also have a potential teratogenic action. Their main side effects are therefore described and discussed as to their physiopathology and treatment. Nevertheless, in spite of their various side effects, neuroleptics represent a valuable and effective tool in the treatment of various psychotic disorders, namely schizophrenia. Their main pharmacological property is their ability to induce extrapyramidal side effects. In this respect, the prophylactic administration of an antiparkinsonian agent remains a controversial issue. Finally, the occurrence of tardive dyskinesia has given rise to civil litigation and ethical considerations should be borne in mind in their use. 4 AUTHOR Bristow MF AUTHOR Kohen D TITLE Neuroleptic malignant syndrome. SOURCE Br J Hosp Med; VOL 55, ISS 8, 1996, P517-20 (REF: 18) ABSTRACT Neuroleptic malignant syndrome is a rare, idiosyncratic condition related to neuroleptic use which may develop at any stage during neuroleptic treatment and can prove fatal. Although most commonly seen in psychiatric patients, anyone prescribed a neuroleptic is at risk and it has been associated with other agents. This article discusses its recognition, risk factors, clinical course and treatment, together with a summary of current thinking on its aetiology. 7 AUTHOR Demirkiran M AUTHOR Jankovic J AUTHOR Dean JM TITLE Ecstasy intoxication: an overlap between serotonin syndrome and neuroleptic malignant syndrome. SOURCE Clin Neuropharmacol; VOL 19, ISS 2, 1996, P157-64 (REF: 43) ABSTRACT 3,4-Methylenedioxymethamphetamine (MDMA), also known as "ecstasy" is a popular recreational drug with potential for abuse. Although its neurotoxic effects have been established in animal studies, the acute and long-term effects of this serotonergic agent in humans are still unknown. We describe a 19-year-old woman with overlapping symptoms of neuroleptic malignant syndrome and serotonin syndrome after a single exposure to MDMA. We also review 15 other cases reported in the literature to draw attention to the serious neurotoxicity, including fatal outcomes, caused by the use of this increasingly popular, illicit drug. 8 AUTHOR Wetli CV AUTHOR Mash D AUTHOR Karch SB TITLE Cocaine-associated agitated delirium and the neuroleptic malignant syndrome. SOURCE Am J Emerg Med; VOL 14, ISS 4, 1996, P425-8 (REF: 18) ABSTRACT The incidence of this previously rare disorder, cocaine-associated agitated delirium, appears to have increased drastically within the last 18 months. The underlying neurochemical abnormalities have recently been characterized, but most clinicians have had little experience with management of agitated delirium. The basic clinical and pathological features of this disorder are reviewed, and common pitfalls in diagnosis and management that frequently lead to needless but very expensive litigation are discussed. 10 AUTHOR Velamoor VR AUTHOR Swamy GN AUTHOR Parmar RS AUTHOR Williamson P AUTHOR Caroff SN TITLE Management of suspected neuroleptic malignant syndrome. SOURCE Can J Psychiatry; VOL 40, ISS 9, 1995, P545-50 (REF: 33) ABSTRACT OBJECTIVE: Neuroleptic Malignant Syndrome (NMS) is a rare but potentially lethal form of drug-induced hyperthermia. The objective of this paper is to provide data regarding early and suspected cases as well as offer guidelines for managing this condition. Knowledge of suspected cases will lead to early recognition and prompt management of this condition in the future. METHOD: To address the gap in knowledge, we present 2 case reports of patients with early NMS-like symptoms. The case reports are followed by a brief review of the literature on differential diagnoses, risk factors, early signs and treatment data. CONCLUSIONS: The most rational approach to treating NMS entails a hierarchy of interventions determined by the severity and progression of symptoms. 12 AUTHOR Crespo Facorro B AUTHOR Carbonell Masia C TITLE [Neuroleptic malignant syndrome: a review of literature] SOURCE Actas Luso Esp Neurol Psiquiatr Cienc Afines; VOL 23, ISS 5, 1995, P273-8 (REF: 57) ABSTRACT Neuroleptic malignant syndrome is characterized by altered consciousness, fever, extrapyramidal signs and autonomic instability. Although originally described in patients receiving neuroleptic drugs, this syndrome may also occur in patients who were taking a wide variety of medications. It is a rare and potentially lethal idiosyncratic reaction that occurs after therapeutic rather than toxic doses of neuroleptics drugs and is unrelated to the duration of therapy. The implications of dopaminergic disturbances underlying the mental illnesses involved are considered. Treatment of the neuroleptic malignant syndrome involves, first of all, supportive measures and withdrawal of the neuroleptic drugs therapy. 15 AUTHOR Murak E TITLE [Neuroleptic malignant syndrome] SOURCE Psychiatr Pol; VOL 29, ISS 3, 1995, P349-58 (REF: 21) ABSTRACT The Neuroleptic Malignant Syndrome (NMS) is characterized e.g.: by increased muscular tone, fever. NMS is the complication during neuroleptic therapy. The base of NMS are changes in the neurotransmitters. The course of NMS is usually typical. Complete NMS develops in a few hours. The course NMS depends on type of the neuroleptic and way of reception. The symptoms of NMS usually remain for several days. Rapid diagnosis and proper treatment are very important for prognosis. People who survived critical state of NMS have good life prognosis but poor outcome (since the return to neuroleptic therapy is impossible). NMS as a subject has an increasing significance because of more frequent usage of neuroleptic in general medicine. 16 AUTHOR Millnamow GA TITLE Neuroleptic malignant syndrome: a clinical conundrum. SOURCE J Okla State Med Assoc; VOL 88, ISS 6, 1995, P256-8 (REF: 28) ABSTRACT The neuroleptic malignant syndrome (NMS) is a potentially fatal complication of antipsychotic pharmacotherapy. The incidence rate of NMS is about 2% of all patients receiving neuroleptics, while the overall mortality rate is in excess of 10%. Inconsistences in the diagnostic criteria for NMS have resulted in a variety of presentations and precipitating factors being associated with this condition, which in turn has led to the reporting of contradictory research findings. This article summarizes the literature with respect to the diagnosis and treatment of neuroleptic malignant syndrome and the challenge of subsequent management of the psychotic patient.