Posted by ace on November 24, 2003, at 22:56:14
In reply to 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.
I think 2% may be a bit overstated- where did you here that figure?
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.
It was actually thought that they would produce EVEN fewer NMS's. Also, I'm not sure that they do infact have a 'weaker dopamine profile'. At equivalant doses I thought their action on dopamine was similiar. I thought there differences lie, a lot, but not always, in their affinity for 5HT receptors.
while designed for the schizophrenias, 'atypicals' as zyprexa and risperdal, etc., were approved for affective disorder patients and have shown efficacy in acute mania.
I don't believe either of these have recieved FDA approval for any 'affective' disorder. I could be wrong.
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.
How fast is 'swiftly'. Did you also experience priapism?
i informed my drs., but they assured me nothing was amiss---even though i was sleeping 16+ hours/day and essentially 'zombied'.
Unfortunately Risperidone, initially, can cause these complaints as s/effects.
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.
Thanks for sharing your experience on this...can you describe any other symptoms you experienced and how this atypical NMS was resolved in your case. I certainly will research this.
Thanks again,
Ace.
poster:ace
thread:283350
URL: http://www.dr-bob.org/babble/20031121/msgs/283451.html