Mortality from neuroleptic malignant syndrome.
The authors assess the mortality from the neuroleptic malignant syndrome (NMS) based on an exhaustive review of 202 published case reports, including a differential assessment of risk factors and protective factors. The results indicate a significant (p less than .05) decrease in mortality since 1984 (11.6% vs. 25% before 1984), which occurs independently of the therapeutic use of dopamine agonists and dantrolene. A significantly (p less than .001) lower rate of mortality from haloperidol-induced NMS (7%) and a high rate of mortality (38.5%) among patients with organic brain syndrome were also found. Myoglobinemia and renal failure are strong predictors of mortality, representing a mortality risk of approximately 50%. The authors discuss the implications of these findings.
Shalev
A
A
Department of Psychiatry, Gehah Psychiatric Hospital, Tel Aviv University, Israel.
Hermesh
H
H
Munitz
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003620:Dantrolene / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D006220:Haloperidol / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000188:drug therapy / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology / Q000401:mortality
D015259:Dopamine Agents; D003620:Dantrolene; D006220:Haloperidol