They have an increased prescription of neuroleptics
and anti-depressants, which indicates that anxiety and depression are over-represented in people with haemophilia.
The third hypothesis involves hyperactivity of the sympathetic nervous system; it is thought that psychologic stressors alter frontal lobe function, with neuroleptics
disrupting the inhibitory pathways of the sympathetic nervous system.
malignant syndrome (NMS) has been conceptualized as an iatrogenic form of malignant catatonia secondary to antipsychotic use (see Table 1) .
A high degree of suspicion must be maintained for any surgical patient taking shortterm or longterm neuroleptics
because, despite its rarity, NMS is potentially fatal.
malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics
, characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia (1).
Hyperthermia, diaphoresis, sialorrhea, akinetic-hypertonic syndrome, stupor, dyspnoea, blood pressure oscillations and oniric confusion syndrome are only some of the symptoms requiring careful supervision in a specialized medical unit, symptomatic treatment and cessation of neuroleptic
medication (2, 3, 4).
Moreover, we compared in two different analyses patients on atypical neuroleptics
monotherapy versus patients with a second atypical neuroleptic
in add-on and patients with atypical neuroleptics
monotherapy versus patients with haloperidol in add-on, with the Mann-Whitney Test.
Malignant Syndrome (NMS) is a medical emergency of rare presentation in a service.
Malignant Syndrome (NMS) is an idiosyncratic and potentially life-threatening reaction to neuroleptic
As Tardive dyskinesia is frequently associated with first generation neuroleptics
, these medications should be used restrictively only in major mental disorder and also doses should be kept low.
Given that treatments for AD and DLB are mostly supportive, this scale is unlikely to change clinical practice dramatically except for alerting physicians that a trial of movement-facilitating therapies such as levodopa/carbidopa and aggressive physical therapy is indicated, and that standard neuroleptics
should be avoided.
(19) Olmsted has suggested the following guidelines for administration of neuroleptics
after NMS resolution.