Neuroleptic Malignant Syndrome

Question 1

DEFINITION

Answer 1

Rare condition seen in patients taking antipsychotics (sometimes atypical antipsychotics)

Also in dopaminergic drugs (levo-dopa)

Mortality = 10%

Question 2

FEATURES

Answer 2

More common young males
Onset usually in in frist 10 days of treatment

Pyrexia
Tachycardia

Question 3

INVESTIGATIONS

Answer 3

BLOODS

• Creatine kinase ++
• Leukocytosis ++

Question 4

MANAGEMENT

Answer 4

Stop antipsychotic
IV fluids to prevent renal failure
Dantrolene may be useful (decreases excitation-contraction coupling in skeletal muscles)
Bromocriptine (dopamine agonist) may be useful