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atypical neuroleptic syndrome

Posted by maxx44 on November 24, 2003, at 18:33:28

neuroleptic malignant syndrome, NMS, a possibly lethal complication of old-line neuroleptics was first noted with haldol, but any classic neuroleptic was found to produce NMS in apprx. 2% of patients. it was thought that the newer 'atypical neuroleptics' would not produce NMS, due to their weaker dopamine blockade profile, the assumed cause. this has been shown as incorrect. while designed for the schizophrenias, 'atypicals' as zyprexa and risperdal, etc., were approved for affective disorder patients and have shown efficacy in acute mania. 3 years ago, as a bipolar with refractory depression, i was put on a risperdal trial of 2mg/day and swiftly experienced incontinence, odd flu-like intermittent fever, leg-muscle rigidity, loss of mental status. i informed my drs., but they assured me nothing was amiss---even though i was sleeping 16+ hours/day and essentially 'zombied'. at that time there was little data on this form of NMS. atypical NMS may appear as the classic form, or a weaker varient. recent studies now term this 'atypical NMS' and call for a 'spectrum' approach. in other words the patient may experience fairly classic NMS, which strikes swiftly and requires immediate icu care and has a 20% mortality rate, or as my case, a slower course, which may or may not escalate to full-blown NMS. i feel my drs. are excellent, but would appreciate any input on this reaction. thank you.


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