Neuroleptic malignant syndrome and atypical antipsychotic drugs.

@article{Ananth2004NeurolepticMS,
  title={Neuroleptic malignant syndrome and atypical antipsychotic drugs.},
  author={Jambur Ananth and Sharat Parameswaran and Sarath Gunatilake and Karl S. Burgoyne and Taghrid Sidhom},
  journal={The Journal of clinical psychiatry},
  year={2004},
  volume={65 4},
  pages={
          464-70
        }
}
OBJECTIVE The incidence of neuroleptic malignant syndrome (NMS) is not known, but the frequency of its occurrence with conventional antipsychotic agents has been reported to vary from 0.02% to 2.44%. DATA SOURCES MEDLINE search conducted in January 2003 and review of references within the retrieved articles. DATA SYNTHESIS Our MEDLINE research yielded 68 cases (21 females and 47 males) of NMS associated with atypical antipsychotic drugs (clozapine, N = 21; risperidone, N = 23; olanzapine, N… 
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Comparison of neuroleptic malignant syndrome induced by first- and second-generation antipsychotics

The clinical profile of 2G-NMS is largely similar to 1G- NMS, with clozapine-induced NMS being differentiated by the relative lack of rigidity as a feature, and Mortality is lower for 2G -NMS.

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  • 2009
The author addressed himself to the issues surrounding the neurotoxic reaction to the treatment regimen containing atypical antipsychotics, focusing on the "atypical" forms of NMS and pathophysiological as well as clinical features of serotonin toxicity.

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Second-Generation Antipsychotics and Neuroleptic Malignant Syndrome: Systematic Review and Case Report Analysis

Systematic analysis of case reports suggests that even the most recently marketed antipsychotics are not free from the risk of inducing NMS, and primary studies suggest that SGA-NMS is characterized by lower incidence, lower clinical severity, and less frequent lethal outcome.

Association Between Selective Serotonin-Reuptake Inhibitors, Second-Generation Antipsychotics, and Neuroleptic Malignant Syndrome

The use of SSRIs may be associated with an increased risk of NMS development in patients receiving second-generation antipsychotics, and Clinicians should closely monitor patients for the potential development of N MS.

Drug information update. Atypical antipsychotics and neuroleptic malignant syndrome: nuances and pragmatics of the association

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Clozapine appears to cause neuroleptic malignant syndrome, although the presentation may be different than that of traditional antipsychotics, and clozAPine-associated NMS may present with fewer clinical features.

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Clinicians should be on the lookout for risperidone-induced neuroleptic malignant syndrome, as 6 patients including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS.

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It is suggested that typical NMS does occur with clozapine and that its incidence may be as common as with the classic neuroleptics and with fewer extrapyramidal side effects and a lower rise in creatine kinase levels.

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A patient treated with quetiapine who presented with biochemical and clinical evidence of neuroleptic malignant syndrome is described, believed that atypical antipsychotics are less likely to cause this condition.

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The method of early recognition and prevention of morbidity as well as mortality is described and it is reported that rechallenge with neuroleptics may not induce Neuroleptic Malignant Syndrome again.
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