title: Precautionary measures reduce risk of definite neuroleptic malignant syndrome in newly typical neuroleptic-treated schizophrenia inpatients.
abstract: Neuroleptic malignant syndrome (NMS) is a potentially lethal antipsychotic drug (APD)-induced thermoregulatory disturbance. We hypothesized that several precautionary measures taken after administeration of APDs might prevent progression to definite NMS. The study group included 657 consecutively admitted drug-free schizophrenia inpatients who received various typical APDs for 28 days. Specific predefined precautionary measures were employed for this group. The comparison group (n=192) consisted of typical APD-treated schizophrenia inpatients in whom such precautionary measures were not imposed. The study group exhibited a significantly lower incidence of definite NMS (1/657=0.2% versus 4/192=2.1%; P=0.01, odds ratio=13.96; 95% confidence interval 1.55-125.63). Antipsychotics were discontinued in 28 patients (28/657=4.3%) from the study group due to NMS (n=1) or early detection of potential NMS-related signs (probable abortive NMS) (n=27). Our findings suggest that specific precautionary measures can effectively reduce the incidence of definite NMS by approximately one order in newly medicated schizophrenia inpatients.
authors.affiliation: Geha Psychiatric Hospital, Felsenstein Medical Research Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Shiloh
authors.forename: Avi
authors.initials: A
authors.lastname: Valevski
authors.forename: Liron
authors.initials: L
authors.lastname: Bodinger
authors.forename: Sagit
authors.initials: S
authors.lastname: Misgav
authors.forename: Dov
authors.initials: D
authors.lastname: Aizenberg
authors.forename: Pnina
authors.initials: P
authors.lastname: Dorfman-Etrog
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Hanan
authors.initials: H
authors.lastname: Munitz
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001831:Body Temperature; D003402:Creatine Kinase / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009127:Muscle Rigidity; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology* / Q000517:prevention & control*; D011379:Prognosis; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D003402:Creatine Kinase