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Neuroleptic Malignant Syndrome treatment

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https://www.readbyqxmd.com/read/30506147/neuroleptic-malignant-syndrome-evaluation-of-drug-safety-data-from-the-amsp-program-during-1993-2015
#1
Michael Schneider, Johannes Regente, Timo Greiner, Stephanie Lensky, Stefan Bleich, Sermin Toto, Renate Grohmann, Susanne Stübner, Martin Heinze
Neuroleptic malignant syndrome (NMS) is a rare, but severe adverse drug reaction of drugs with anti-dopaminergic properties. The main symptoms are fever and rigor. In addition, other symptoms such as creatine kinase elevation, alteration of consciousness and various neurological symptoms may occur. A total of 52 NMS cases have been documented in the drug safety program 'Arzneimittelsicherheit in der Psychiatrie' from 1993 to 2015. We calculated incidences and analyzed imputed substances and additional risk factors to study the impact of changing therapy regimes...
November 30, 2018: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/30501608/acute-phenibut-withdrawal-a-comprehensive-literature-review-and-illustrative-case-report
#2
REVIEW
Matthew I Hardman, Juraj Sprung, Toby N Weingarten
Phenibut is a glutamic acid derivative with activity on the γ-aminobutyric acid (GABA) B and A, and β-phenethylamine receptors. It is prescribed in former Communist Bloc countries for anxiolysis and related psychiatric disorders. It can be easily obtained in Western countries, and is thought to have abuse potential. Abrupt discontinuation has been reported to precipitate an abstinence syndrome. A review of the literature identified 22 reported cases, many of which were notable for severe psychomotor agitation and requirements for aggressive pharmacologic treatment...
December 3, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/30459031/neuroleptic-malignant-syndrome-and-serotonin-syndrome
#3
Laura M Tormoehlen, Daniel E Rusyniak
The clinical manifestation of drug-induced abnormalities in thermoregulation occurs across a variety of drug mechanisms. The aim of this chapter is to review two of the most common drug-induced hyperthermic states, serotonin syndrome and neuroleptic malignant syndrome. Clinical features, pathophysiology, and treatment strategies will be discussed, in addition to differentiating between these two syndromes and differentiating them from other hyperthermic or febrile syndromes. Our goal is to both review the current literature and to provide a practical guide to identification and treatment of these potentially life-threatening illnesses...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/30439816/neuroleptic-malignant-syndrome-in-a-patient-treated-with-clotiapine
#4
Clémentine Lantin, Miriam Franco, François-Xavier Dekeuleneer, Didier Chamart, Juan Martin Tecco
BACKGROUND: Neuroleptic malignant syndrome (NMS), which is linked to the use of antipsychotic medication, is a potentially lethal neurological emergency. The interest of our study is that NMS induced by the use of clotiapine has never previously been described. SUBJECTS AND METHODS: We present the case of a 61-year old man whose sleep disorders were treated with clotiapine 40 mg/day. After 7 days of taking 40 mg clotiapine, the patient presented with a deterioration of his general health which had gradually taken hold, with altered consciousness accompanied by generalised muscle rigidity and hypersalivation...
November 2018: Psychiatria Danubina
https://www.readbyqxmd.com/read/30396751/consideration-of-occult-infection-and-sepsis-mimics-in-the-sick-patient-without-an-apparent-infectious-source
#5
Marina N Boushra, Susan N Miller, Alex Koyfman, Brit Long
BACKGROUND: Evaluation and treatment of the acutely ill patient is typically complicated by multiple comorbidities and incomplete medical histories. This is exemplified by patients with sepsis, whose care is complicated by variable presentations, shifting definitions, and a variety of potential sources. Many practitioners fail to consider and recognize less-common sources of infection in a timely manner. Additionally, multiple noninfectious conditions can present with the fever and tachycardia typical of the septic patient...
November 2, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30254795/atypical-neuroleptic-malignant-syndrome-precipitated-by-clozapine-and-quetiapine-overdose-a-diagnostic-challenge
#6
David Choon Liang Teo, Hon Khuan Wong, Sheng Neng Tan
Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic, but life-threatening adverse reaction associated with the use of antipsychotic drugs. It is characterized by a tetrad of fever, rigidity, autonomic instability, and altered mental status. Failure to diagnose NMS early and institute appropriate treatment can result in serious medical complications and death. While diagnostic criteria for NMS exist, atypical presentations that lack one or more characteristic features pose a diagnostic dilemma to clinicians...
July 2018: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/30128733/-antipsychotic-induced-motor-symptoms-in-schizophrenic-psychoses-part-2-catatonic-symptoms-and-neuroleptic-malignant-syndrome
#7
REVIEW
D Hirjak, A Sartorius, K M Kubera, R C Wolf
In rare cases, pharmacotherapy in schizophrenic psychoses can be associated with life-threatening antipsychotic-induced movement disorders. The two most severe complications are antipsychotic-associated catatonic symptoms (ACS) and neuroleptic malignant syndrome (NMS). Although both constellations necessitate rapid medical care, the diagnosis is still a clinical challenge. Although there is no established treatment of ACS (here designated as a specific subtype of catatonic symptoms), an attempt should be made with benzodiazepines and memantine can also be helpful...
August 20, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/30112240/a-case-of-neuroleptic-malignant-syndrome-in-a-profoundly-intellectually-disabled-patient-with-successful-reintroduction-of-antipsychotic-therapy-with-quetiapine
#8
Kamal Patel, Brandon Lilly, Oluwadamilare Ajayi, Kelly Melvin
Neuroleptic Malignant Syndrome (NMS) is a rare condition clinically characterized by muscle rigidity, hyperthermia, autonomic instability, and acute mental status change. NMS is most often associated with use of high-potency first-generation antipsychotic medications; though, other neuroleptics have been implicated as well. NMS can be fatal with estimated mortality rates as high as 20%. Patients experiencing certain severe complications, including renal failure, have been associated with mortality as high as 50%, stressing the need for early recognition and treatment...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/30087734/forced-diuresis-and-expedient-blood-pressure-control-in-the-management-of-quetiapine-induced-neuroleptic-malignant-syndrome-a-case-report
#9
Neville Aquilina, Vincent Bugeja
BACKGROUND: This case report intends to highlight the importance of safeguarding renal function from rhabdomyolysis in neuroleptic malignant syndrome (NMS) by concomitant administration of parenteral fluids at a high rate together with high doses of parenteral loop diuretics (we utilised 6 mg bumetanide daily) and tailed over a few days, in order to preserve glomerular/renal medullary perfusion and nephron function. CASE REPORT: This case describes an elderly lady previously diagnosed with Lewy body dementia who had been started on low dose quetiapine a few days previously and presented with an acute 24 - 48 hour onset of fever, generalised stiffness, rapidly becoming uncommunicable and with high blood pressure...
July 20, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29992532/refining-the-psychiatric-syndrome-of-anti-n-methyl-d-aspartate-receptor-encephalitis
#10
REVIEW
N Warren, D Siskind, C O'Gorman
OBJECTIVE: To review the psychiatric symptoms of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, in an attempt to differentiate the presentation from a primary psychiatric disorder. METHOD: A systematic literature review of PubMed and EMBASE of all published cases of anti-NMDA receptor encephalitis was performed from inception to January 2018. RESULTS: There were 706 cases of anti-NMDA receptor encephalitis identified. Cases were typically young (mean age 22...
November 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29992074/diagnostic-treatment-and-system-challenges-in-the-management-of-recurrent-neuroleptic-malignant-syndrome-on-a-general-medical-service
#11
Karan Verma, Vivek Jayadeva, Raymond Serrano, Karthik Sivashanker
Neuroleptic malignant syndrome (NMS), an iatrogenic form of malignant catatonia, carries high morbidity and mortality rates especially in the context of delayed recognition and standard intervention protocol of lorazepam trial. However, there is limited guidance available through literature for further management if benzodiazepine treatment is ineffective and electroconvulsive therapy (ECT) is not readily accessible. This case report describes a multimodal approach to address the diagnostic, treatment, and logistical system challenges in an acute medical hospital through the case of a 69-year-old man with schizophrenia who represented from a psychiatric ward with neuroleptic malignant syndrome...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29866205/effects-of-dexmedetomidine-on-delirium-duration-of-non-intubated-icu-patients-4d-trial-study-protocol-for-a-randomized-trial
#12
Clémence Louis, Thomas Godet, Gérald Chanques, Nathalie Bourguignon, Dominique Morand, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: Delirium during intensive care unit (ICU) stay is frequent and associated with significant morbidity, mortality and healthcare-related costs. International guidelines suggest its prevention. However, curative treatment remains unclearly established. Despite contradictory and ambiguous academic literature, international guidelines suggest the use of second-generation (atypical) antipsychotics over haloperidol. However, haloperidol remains the most widely used neuroleptic worldwide as a first-line treatment of agitation and/or delirium...
June 4, 2018: Trials
https://www.readbyqxmd.com/read/29864758/electroconvulsive-therapy-general-considerations-and-experience-in-croatia
#13
Alma Mihaljević-Peleš, Maja Bajs Janović, Ana Stručić, Marina Šagud, Milena Skočić HanŽek, Maja Živković, Špiro Janović
Despite controversy, ECT has been recognized as significantly effective for the treatment of mental disorders since 1938, when Cerletti and Bini introduced ECT in clinical psychiatric practice for treatment of schizophrenia. In the next period, indication for ECT switched more toward depression and catatonia. ECT was even banned from psychiatric training in 1960's, due to the anti-psychiatric movement, which were fortified by Oscar winning movie "One Flew over the Cuckoo's Nest". Due to its robust effectiveness, ECT revived in the early 1980's and today holds its position in clinical psychiatric practices around the world...
June 2018: Psychiatria Danubina
https://www.readbyqxmd.com/read/29548378/dantrolene-for-treatment-of-suspected-neuroleptic-malignant-syndrome
#14
Colleen J Whyte, Jamie M Rosini
No abstract text is available yet for this article.
March 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29505490/clozapine-rechallenge-after-major-adverse-effects-clinical-guidelines-based-on-259-cases
#15
REVIEW
Peter Manu, Yevgeniya Lapitskaya, Atef Shaikh, Jimmi Nielsen
BACKGROUND: Clozapine is widely prescribed for treatment-refractory schizophrenia, but its use is limited by many potentially life-threatening adverse effects. The risk of rechallenge after these complications has never been comprehensively assessed in controlled studies. Thus, clinical guidelines must rely on the published case reports. The number of such reports is likely to increase over time, and updated analyses of larger samples are needed, as they may lead to changes in clinical guidelines...
March 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29475219/a-neuroleptic-malignant-syndrome-without-rigidity
#16
İlker Özdemir, Erkan Kuru, Yasir Safak, Rıza Gökçer Tulacı
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially lethal idiosyncratic reaction which may emerge in the aftermath of the treatments with neuroleptics demonstrating itself with the symptoms of altered consciousness, high fever, impaired autonomic functions, and muscle rigidity. Although various risk factors have been identified for NMS, its etiology is not completely known. The mortality and morbidity related with NMS could be reduced by early diagnosis, interruption of the neuroleptics used within a short period and aggressive treatment...
February 2018: Psychiatry Investigation
https://www.readbyqxmd.com/read/29441189/neuroleptic-malignant-syndrome-a-case-responding-to-electroconvulsive-therapy-plus-bupropion
#17
Quintí Foguet-Boreu, Montse Coll-Negre, Montse Serra-Millàs, Miquel Cavalleria-Verdaguer
Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT...
January 8, 2018: Clinics and Practice
https://www.readbyqxmd.com/read/29325237/neuroleptic-malignant-syndrome-diagnosis-and-management
#18
REVIEW
Michael R Ware, David B Feller, Karen L Hall
Objective: To provide an overview of neuroleptic malignant syndrome (NMS) for the general practitioner with the most up-to-date information on etiology, workup, and management. Data Sources: The search using PubMed included articles with the key words neuroleptic malignant syndrome, antipsychotics, neuroleptics, diagnosis, and treatment of neuroleptic malignant syndrome published in English from January 2000 to 2017. Single-case reports and articles dealing with the pediatric patient population were excluded...
January 4, 2018: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29230342/the-treatment-of-clozapine-withdrawal-delirium-with-electroconvulsive-therapy
#19
Anish Modak, Arne Åhlin
Clozapine, a commonly used atypical antipsychotic, can precipitate a severe withdrawal syndrome. In this report, we describe a case of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developing neuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) was initiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromes of varied symptomatology treated with ECT...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29209753/-neuroleptic-malignant-syndrome
#20
REVIEW
R Knorr, J Schöllkopf, E Haen
BACKGROUND: Neuroleptic malignant syndrome (NMS) is a rare but severe undesired complication of psychopharmacological treatment. The mortality has shown a significant decrease since its first description. Knowledge of NMS is important for every clinician because of the need for rapid diagnosis and treatment. OBJECTIVE: This article presents a review and critical appraisal of the current study situation for NMS. Recommendations for diagnostics, differential diagnostics and treatment are presented particularly from a clinical perspective...
March 2018: Der Nervenarzt
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