Neuroleptic malignant syndrome

Neuroleptic malignant syndrome can occur with all the neuroleptics but haloperidol and trifluperazine are the most common. About 0.5-1% of patients exposed to neuroleptics develop this syndrome. The classic triad involves the autonomic nervous system (fever in 100%), the extra pyramidal system (rigidity), and cognitive changes. High CPK and leucocytosis and iron deficiency anaemia is seen in these patients. The first phase of treatment is supportive therapy with adequate hydration and metabolite (electrolyte) stabilization. . Drug therapy starts with discontinuing the neuroleptic. Dantrolene sodium and bromocriptine are the drugs used for treatment.


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