The primary trigger of NMS is dopamine receptor blockade and the standard causative agent is an antipsychotic. Potent typical neuroleptics such as haloperidol, fluphenazine, chlorpromazine, trifluoperazine, and prochlorperazine have been most frequently associated with NMS and thought to confer the greatest risk.
What medications cause neuroleptic malignant syndrome?
Any antipsychotic drug can cause NMS. But stronger drugs, like fluphenazine and haloperidol, are more likely to trigger it.
- Chlorpromazine (Thorazine)
- Fluphenazine (Prolixin)
- Haloperidol (Haldol)
- Loxapine (Loxitane)
- Perphenazine (Etrafon)
- Thioridazine (Mellaril)
Which medication poses the greatest risk for neuroleptic malignant syndrome?
Causes. NMS is usually caused by antipsychotic drug use, and a wide range of drugs can result in NMS. Individuals using butyrophenones (such as haloperidol and droperidol) or phenothiazines (such as promethazine and chlorpromazine) are reported to be at greatest risk.
Can succinylcholine cause neuroleptic malignant syndrome?
Neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) may have a common pathogenic mechanism; therefore, it has been suggested that known triggering agents for MH (such as succinylcholine) should be avoided in patients with NMS.
Can risperidone cause neuroleptic malignant syndrome?
Clinicians need to be aware that NMS can occur with risperidone, despite the markedly lower incidence of extrapyramidal symptoms. In patients with neurodegenerative disorders, caution should be exercised in prescribing even atypical agents, and a high index of suspicion for NMS should be maintained.
What causes neuroleptic syndrome?
Neuroleptic malignant syndrome comes about, most likely, as a result of “dopamine D2 receptor antagonism”. Dopamine is a chemical substance (neurotransmitter) found in the brain and elsewhere in the central nervous system that acts to convey messages from one cell to another.
Why do antipsychotics cause neuroleptic malignant syndrome?
The most widely accepted mechanism by which antipsychotics cause neuroleptic malignant syndrome is that of dopamine D2 receptor antagonism. In this model, central D2 receptor blockade in the hypothalamus, nigrostriatal pathways, and spinal cord leads to increased muscle rigidity and tremor via extrapyramidal pathways.
What is a neuroleptic medication?
Neuroleptics, also known as antipsychotic medications, are used to treat and manage symptoms of many psychiatric disorders. They fall into two classes: first-generation or “typical” antipsychotics and second-generation or “atypical” antipsychotics.” Neuroleptic drugs block dopamine receptors in the nervous system.
Can lithium cause neuroleptic malignant syndrome?
Neuroleptic malignant syndrome associated with atypical antipsychotic drugs. The literature contains several case reports of lithium-associated NMS, particularly when lithium was given in combination with antipsychotics or dopaminergic agents.
What should the nurse do if neuroleptic malignant syndrome occurs?
Treatment of patients with neuroleptic malignant syndrome may include the following:
- Benzodiazepines for restraint may be useful.
- Stop all neuroleptics.
- Correct volume depletion and hypotension with intravenous fluids.
- Reduce hyperthermia.
Is neuroleptic malignant syndrome and malignant hyperthermia same?
The pathogenesis and cause of neuroleptic malignant syndrome remain unclear. Malignant hyperthermia (MH) is an acute life-threatening hypermetabolic syndrome that occurs in susceptible individuals during exposure to inhalational anesthetic gases or the depolarizing neuromuscular blocker succinylcholine.
Can olanzapine cause neuroleptic malignant syndrome?
Neuroleptic malignant syndrome can occur with atypical antipsychotic drugs such as olanzapine, particularly when risk factors are present. We should pay attention to this rare but life-threatening event associated with fatal complications.
What can cause malignant hyperthermia?
Malignant hyperthermia susceptibility (MHS) is caused by a genetic defect (mutation). The abnormal gene increases your risk of malignant hyperthermia when you’re exposed to certain anesthesia medications that trigger a reaction. The abnormal gene is most commonly inherited, usually from one parent who also has it.
What is the difference between serotonin syndrome and neuroleptic malignant syndrome?
NMS and serotonin syndrome are rare, but potentially life-threatening, medicine-induced disorders. Features of these syndromes may overlap making diagnosis difficult. However, NMS is characterised by ‘lead-pipe’ rigidity, whilst serotonin syndrome is characterised by hyperreflexia and clonus.
What is risperidone used for?
Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder. This medicine should not be used to treat behavioral problems in older adults who have dementia. This medicine is available only with your doctor’s prescription.
Can risperidone cause serotonin syndrome?
Olanzapine and risperidone, atypical antipsychotics, have been paradoxically reported to both induce a serotonin syndrome and to treat this syndrome. A case report by Haslett and Kumar noted the development of serotonin syndrome after olanzapine was added to a drug regimen of lithium and citalopram.