Neuroleptic-induced neuroleptic malignant syndrome (NMS) is a severe and potentially life-threatening condition that can occur as a rare side effect of certain medications known as neuroleptics or antipsychotics. It is characterized by a collection of symptoms that affect the nervous system and can have serious consequences if not promptly recognized and treated.
NMS typically arises as a result of the use of high-potency neuroleptic drugs, especially when they are administered at high doses or rapidly increased in dosage. The syndrome is thought to be caused by disruption of the dopamine system in the brain, leading to a dysfunction of the basal ganglia, a region involved in movement control.
Symptoms of NMS include severe muscle rigidity, high fever, altered mental status, autonomic dysfunction (such as fluctuations in blood pressure, increased heart rate, sweating), and evidence of muscle breakdown, which may be indicated by elevated blood levels of creatine phosphokinase (CPK). These symptoms can progress rapidly and may lead to complications such as rhabdomyolysis, renal failure, and even death if not appropriately managed.
Treatment of NMS involves immediate discontinuation of the offending medication and hospitalization in an intensive care setting. Supportive care and monitoring of vital signs, fluid balance, and organ function are crucial. In severe cases, interventions such as cooling measures, muscle relaxants, and medications to regulate dopamine may be necessary.
It is important for healthcare professionals to identify and promptly manage NMS, as delayed recognition can lead to serious complications. Patients and caregivers should also be aware of the signs and symptoms, especially when starting or adjusting neuroleptic medications, in order to seek immediate medical attention if NMS is suspected.
