Neuroleptic Malignant Syndrome in Patients Treatedat the Intensive Psychiatric Care Unit of the Psychiatric Clinic in Brno

Overview

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 first24-72 hours of neuroleptic treatment, mostly it is manifested in the first four weeks of neuroleptictherapy. Most often it has been observed after administration of higher or rapidly increased dosesof incizive neuroleptics. Higher risk of NMS appearance is observed in patients with organicbrain 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 2men 14 to 59 old. All patients were treated with incisive neuroleptics for a psychotic episode. In 7cases it was the first manifestation of mental illness. NMS treatment consisted of immediatecessation of neuroleptic medication and application of dantrolene, dopamine agonists, and symptomatic therapy. We did not record any mortality. The most serious complication was repeatedrespiratory insufitience in one patient.

Key words:
neuroleptic malignant syndrome, neuroleptic drugs, creatine phosphokinase.