What are the signs and symptoms of neuroleptic malignant syndrome?

Symptoms of neuroleptic malignant syndrome usually include very high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure.

How long does it take for NMS to resolve?

The most important intervention is to discontinue all neuroleptic agents. In most cases, symptoms will resolve in 1-2 weeks. Episodes precipitated by long-acting depot injections of neuroleptics can last as long as a month.

How long does it take to recover from neuroleptic malignant syndrome?

NMS usually gets better in 1 to 2 weeks. After recovery, most people can start taking antipsychotic medicine again. Your doctor might switch you to a different drug.

What is neuroleptic syndrome?

INTRODUCTION Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency associated with the use of antipsychotic (neuroleptic) agents and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia.

Can clozapine cause neuroleptic malignant syndrome?

Conclusions: Clozapine appears to cause NMS, although the presentation may be different than that of traditional antipsychotics. Levenson’s original and Addonizio’s modified criteria were more likely to diagnose NMS than were other criteria. Clozapine-associated NMS may present with fewer clinical features.

Is gabapentin an antipsychotic medication?

Gabapentin (GBP) is a neuroleptic drug with anticonvulsant properties also used in the prevention of seizures, treatment of mood disorders, anxiety, tardive dyskinesia, neuropathic pain and limb tremor [47–52].

What should the nurse do if neuroleptic malignant syndrome occurs?

Treatment of patients with neuroleptic malignant syndrome may include the following:

  1. Benzodiazepines for restraint may be useful.
  2. Stop all neuroleptics.
  3. Correct volume depletion and hypotension with intravenous fluids.
  4. Reduce hyperthermia.

What is neuroleptic malignant syndrome caused by?

Neuroleptic malignant syndrome (NMS) is a severe disorder caused by an adverse reaction to medications with dopamine receptor-antagonist properties or the rapid withdrawal of dopaminergic medications.

Can you have NMS without a fever?

These three cases illustrate the point that NMS can occur without fever. Our patients had all the features of NMS apart from fever and the response to bromocriptine can be taken as strong evidence that the diagnosis was accurate.

What is the pathophysiology of malignant catatonia after abrupt clozapine withdrawal?

We report a case of excited catatonia with fever, autonomic instability, and delirium–a picture of malignant catatonia (lethal catatonia) after abrupt clozapine withdrawal. The use of conventional neuroleptics transformed the excited malignant catatonia into a stuporous state resembling neuroleptic malignant syndrome (NMS).

What are the signs and symptoms of clozapine withdrawal?

The withdrawal of clozapine in addition might be characterized by abrupt and severe agitation, abnormal movements and disturbance of conscience level up to delirium. Profound diaphoresis, incontinence, insomnia and psychotic symptoms have also been described ( Stanilla et al., 1997 ).

Is neuroleptic malignant syndrome a variant of catatonia?

The use of conventional neuroleptics transformed the excited malignant catatonia into a stuporous state resembling neuroleptic malignant syndrome (NMS). Such a transformation of excited lethal catatonia into NMS has been described in the literature, providing support for the hypothesis that NMS is a variant of catatonia.

What are the symptoms of antipsychotic withdrawal?

The symptoms of classical antipsychotic withdrawal have been recognized since their earliest use and are relatively common and mild. These symptoms are thought to be due to cholinergic rebound, including nausea, vomiting, marked diaphoresis, increased sebaceous secretion and restlessness, along with general physical complaints.