Monday, April 25, 2005

A dreaded side effect

Via Kevin, MD:

A local man dies of neuroleptic malignant syndrome at a psychiatric hospital

NMS is an uncommon side effect of antipsychotic meds. It affects 0.2-0.5% of patients treated with conventional antipsychotics, and is less common with newer, second-generation meds (like clozapine).

Patients with NMS develop high fever and severe muscle rigidity. Flexing their limbs is like bending a "lead pipe." They appear acutely ill, with unstable vital signs. They can be agitated, lethargic, confused, or unarousable. Muscles and kidneys can be severely damaged.

These patients need emergency care. Deaths have been reported in 11-18% of NMS patients. Survival is improved if it's recognized and treated immediately. It's critical to stop the antipsychotic, start aggressive hydration, and reduce the fever. More on NMS here.

The risk of NMS is one of many factors that we weigh, when deciding whether to prescribe antipsychotics...
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