Algorithms for the treatment of acute side effects induced by neuroleptics.
This article focuses especially on acute extrapyramidal symptoms (EPS) and neuroleptic malignant syndrome (NMS) induced by antipsychotic treatments. Strategies for the management of acute EPS may include changing the neuroleptic (NL) to an alternative one, i.e. switching to a low-potency or an atypical antipsychotic, lowering the dosage or discontinuing the NL, and adding a drug effective in treating EPS. The important factors in the management of NMS are early recognition, immediate discontinuation of antipsychotic medications and prompt institution of supportive care. Dantrolene and/or bromocriptine are found to be the most effective for the second-step treatment of NMS in Japan.
Kusumi
I
I
Department of Psychiatry, Hokkaido University School of Medicine, Sapporo, Japan.
Koyama
T
T
D000465:Algorithms; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000188:drug therapy; D001971:Bromocriptine / Q000008:administration & dosage* / Q000009:adverse effects; D003620:Dantrolene / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007564:Japan; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D009125:Muscle Relaxants, Central; D001971:Bromocriptine; D003620:Dantrolene