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Neuroleptic Malignant Syndrome treatment

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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
#1
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
#2
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
#3
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...
July 10, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29144549/zuclopenthixol-dihydrochloride-for-schizophrenia
#14
REVIEW
Edward J Bryan, Marie Ann Purcell, Ajit Kumar
BACKGROUND: Oral zuclopenthixol dihydrochloride (Clopixol) is an anti-psychotic treatment for people with psychotic symptoms, especially those with schizophrenia. It is associated with neuroleptic malignant syndrome, a prolongation of the QTc interval, extra-pyramidal reactions, venous thromboembolism and may modify insulin and glucose responses. OBJECTIVES: To determine the effects of zuclopenthixol dihydrochloride for treatment of schizophrenia. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Trials Register (latest search 09 June 2015)...
November 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29122973/capsaicin-cream-for-treatment-of-cannabinoid-hyperemesis-syndrome-in-adolescents-a-case-series
#15
Jessica Graham, Michael Barberio, George Sam Wang
Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome...
December 2017: Pediatrics
https://www.readbyqxmd.com/read/29026773/neuroleptic-malignant-syndrome-in-a-patient-with-stable-dose-of-olanzapine
#16
Manoj Kumar Sahoo, Sangita Kamath, Abhijeet Sharan
Neuroleptic malignant syndrome (NMS), a potentially fatal consequence due to typical neuroleptics, has been described so far. In the past few years, there has been increased use of atypical antipsychotic drugs. Cases of NMS related to atypical neuroleptics, such as olanzapine, are less common in spite of increasing cases reported in literatures. Here, we report a case of NMS in a patient with bipolar affective disorder on maintenance treatment with 5 mg olanzapine for the last 7 year. He was successfully treated with bromocriptine and discharged in stable condition in 10 days...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28953679/neuroleptic-malignant-syndrome-with-thyroid-disorder-an-unusual-case-report
#17
Fan Zhang, Parisa Kanzali, Vadim Rubin, Chris Paras, Joel Goldman
RATIONALE: Neuroleptic malignant syndrome (NMS) is a life threatening neurologic emergency associated with neuroleptic or antipsychotic agent use. NMS is rarely related to thyroid disease. PATIENT CONCERNS: We report a case of NMS in a 66-year-old male with past medical history of paranoid schizophrenia on chlorpromazine, diabetes, hypertension and asthma, who presented with a humeral fracture after a fall. Patient developed hyperpyrexia, altered consciousness, autonomic instability, elevated serum creatine kinase (CK) without rigidity...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28943586/-brief-aripiprazole-induced-neuroleptic-malignant-syndrome-with-symptoms-that-only-lasted-a-few-hours
#18
Naoto Mizumura, Masato Uematsu, Aya Ito, Satoshi Okumura, Hiromitsu Maehira, Masao Ogawa, Masayasu Kawasaki
Neuroleptic malignant syndrome (NMS) with characteristic symptoms is a potentially lethal reaction to antipsychotic drugs. Atypical NMS usually lacks major symptoms and frequently occurs after treatment using atypical antipsychotics, such as aripiprazole. A 64-year-old man developed aripiprazole-induced NMS after surgery, and our early recognition of the NMS was based on high creatine kinase levels and low serum iron levels. His characteristic symptoms (a fever, rigidity, and altered mental status) were only present for a few hours and were resolved by aripiprazole discontinuation and supportive care...
November 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28943544/malignant-syndrome-and-serotonin-syndrome-in-a-general-hospital-setting-clinical-features-frequency-and-prognosis
#19
Akiyuki Hiraga, Satoshi Kuwabara
Objective The differences in the frequency and clinical features of malignant syndrome (MS) and serotonin syndrome (SS) in same population have only rarely been reported. To report the frequency and clinical features of MS and SS in a general hospital setting. Methods The clinical and laboratory features of patients with MS and those with SS, who were consecutively admitted to Chiba Rosai Hospital, during the past 4.5 years were reviewed. Results Of the 2005 patients admitted, MS was observed in 16 patients (0...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28789764/-treatment-of-hyperthermia
#20
Sofie Søndergaard Mørch, Johnny Dohn Holmgren Andersen, Morten Heiberg Bestle
Hyperthermia is an uncontrolled elevation of body temperature exceeding the body's ability to dissipate heat. Hyperthermia can result in dangerously high core temperatures and can rapidly become fatal. Common causes include heat stroke, malignant hyperthermia, serotonin syndrome, neuroleptic syndrome, a few endocrine emergencies as well as numerous intoxications. Rapid diagnosis and prompt cooling are pivotal, since the condition triggers a cascade of metabolic events which may progress to irreversible injury or death...
July 24, 2017: Ugeskrift for Laeger
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