Neuroleptic Malignant Syndrome NMS

1. NMS is a rare idiosyncratic reaction which can be fatal. All neuroleptics, with the exception of clozapine, may produce NMS. The risk of NMS with atypical antipsychotics is unclear but appears to be substantially decreased.

2. NMS is characterized by severe muscle rigidity, fever, altered mental status, and autonomic instability.

3. Laboratory tests often reveal an elevated WBC, CPK, and liver transaminases.

4. Treatment involves discontinuing the neuroleptic immediately, along with supportive treatment and medications such as amantadine, bromocriptine, and dantrolene. Patients may require treatment in an intensive care unit.

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