Summary:
Neuroleptic malignant syndrome (NMS) is a serious complication in neuroleptic treatment, potentionally threatening the patients’ lives. NMS is characterized by remarkable muscle rigidity,
hyperthermia, autonomic dysfunction and mental status changes. It can develop during the first
24-72 hours of neuroleptic treatment, mostly it is manifested in the first four weeks of neuroleptic
therapy. Most often it has been observed after administration of higher or rapidly increased doses
of incizive neuroleptics. Higher risk of NMS appearance is observed in patients with organic
brain disorders, dehydrated, cachectic and agitated patients. NMS incidence is about 0.2 - 0.3 %
patients treated with neuroleptics, mortality 20 - 30 %.
At the Intensive Psychiatric Care Unit in Brno, there were 8 patients hospitalised during 5 years,
who were suffering from malignant neuroleptic syndrome. The group comprised 6 women and 2
men 14 to 59 old. All patients were treated with incisive neuroleptics for a psychotic episode. In 7
cases it was the first manifestation of mental illness. NMS treatment consisted of immediate
cessation of neuroleptic medication and application of dantrolene, dopamine agonists, and symptomatic therapy. We did not record any mortality. The most serious complication was repeated
respiratory insufitience in one patient.
Key words:
neuroleptic malignant syndrome, neuroleptic drugs, creatine phosphokinase.
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