Antipsychotic drugs are commonly prescribed in patients with various psychiatric illnesses (e.g. psychosis, schizophrenia, aggressive behavior, etc.). A neurological emergency may arise characterized by muscle rigidity and damage, increased body temperature and cardio-respiratory system instability in patients taking these antipsychotic drugs (also known as neuroleptic drugs; hence the name of the syndrome). The syndrome can be life threatening if not recognized and intervened early enough and therefore, a high index of suspicion is required by the physicians. The offending drug has to be withheld immediately and patients usually require intensive care unit admission.

Modi et al analyzed data of 1346 cases admitted to hospitals in United States due to neuroleptic malignant syndrome. Median age was 52 years and majority of cases occurred between the ages of 39 and 66 years. The proportion of male cases (59%) was slightly higher than that of female (41%).

Death rate within the hospital was 8.3% in year 2002 and decreased to 5.1% in year 2011. Such a significant reduction in death over one decade may be attributed to improved treatment in the intensive care units.

The study also looked at common complications that occurred during the hospital stay. Muscle breakdown (a.k.a. rhabdomyolysis) was found in almost one third of the patients. Muscle breakdown products can damage kidneys, which occurred in 18% patients. Seizures occurred in 13% cases and serious infection was found in 6% cases. About 16% patients had respiratory failure, which was the strongest factor associated with death.

In conclusion, the study utilized a large number of patients to identify rates of complications, death rate and factors associated with death. This information can be valuable to the treating physicians, especially to identify factors predicting death.

Publication

Neuroleptic Malignant Syndrome: Complications, Outcomes, and Mortality.
Modi S, Dharaiya D, Schultz L, Varelas P.
Neurocrit Care. 2015 Jul 30

Read offline:     

Related Articles:

	Sleep abnormalities in different clinical stages of… Sleep abnormalities are commonly observed in individuals with schizophrenia and related psychotic disorders. Research shows that over half of people with these conditions have trouble sleeping. Poor sleep also often…
	UCLA researchers develop high-sensitivity… A significant advancement for point-of-care medical diagnostics, a team of researchers from UCLA has introduced a deep learning-enhanced, paper-based vertical flow assay (VFA) capable of detecting cardiac troponin I (cTnI)…
	Looking inside the heart: how multiple chronic… The aim of this study was to understand how having several ongoing health problems—what we refer to as multimorbidity—impacts the heart in people with cardiovascular disease, especially those undergoing heart…
	Can we accurately diagnose different clinical… Progressive Supranuclear Palsy (PSP) is the second most common degenerative parkinsonian syndrome after idiopathic Parkinson’s disease. PSP is a clinically heterogeneous disorder with several clinical variants. The two most common…
	Improving assessment of arthritis models to better… Rheumatoid Arthritis (RA) is a common inflammatory disease that is characterized by swelling and tenderness of multiple joints. The resulting pain and joint stiffness cause disability for patients and treatment…
	Systemic therapy in juvenile localized scleroderma Juvenile localized scleroderma, also known as morphea, is an rare condition, it occurs around 1 in 5000 children, where the skin and the tissues underneath the skin like fat tissue,…