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I am a bit worried-Neuroleptic Malignant Syndrome » EERRIICC

Posted by Jedi on August 21, 2005, at 11:59:33

In reply to Re: Help Ed, Linkage, Scott, or another med jedi., posted by EERRIICC on August 20, 2005, at 7:20:32

> I'm thinking of taking one or two days off a week.

I am a bit worried about all of the dopamine agonists and other dopaminergic medications you are taking. Although rare, Neuroleptic Malignant Syndrome or "dopaminergic malignant syndrome" can result from the sudden withdrawal of dopaminergic drugs. This condition is fatal about 11% of the time. Some studies say 20% but with better recognition today, it is lower. When you start talking about two day drug holidays, it makes me think of some possible, very negative, consequences.

What did they treat you with in the ICU. NMS is often mistaken for serotonin syndrome because it is so rare. Most cases are caused by people taking the antipsychotic drugs and dopamine agonists are then often used as a treatment. But some cases of NMS or "dopaminergic malignant syndrome" are caused by the abrupt withdrawal of the dopaminergic drugs, mostly in Parkinson's patients.

I Care,

“…NMS occurs from prolonged exposure to neuroleptic agents or withdrawal of dopamine agonists, and there is lead-pipe rigidity with NMS, in contrast to myoclonus or hyperreflexia seen in persons with serotonin syndrome.”

1: Singapore Med J. 2001 Feb;42(2):85-8.
Neuroleptic malignant syndrome without neuroleptics.
Ong KC, Chew EL, Ong YY.
Department of Respiratory & Critical Care Medicine, Singapore General Hospital.
Neuroleptic malignant syndrome is an uncommon condition characterised by hyperthermia, rigidity, altered mentation and autonomic instability. Recognition of this condition is essential because its complications are potentially lethal, leading to death in 20% of patients. Not all cases of this syndrome are associated with the use of neuroleptics and there is an increasing number of reports of this condition occurring after withdrawal of therapy with dopaminergic drugs, typically in patients with Parkinsonism. In this setting, there is tremendous potential for misdiagnosis and delay in institution of treatment because of the traditional and common association of the syndrome with the use of neuroleptics only. We report a case of neuroleptic malignant syndrome in a patient with Parkinsonism subsequent to the withdrawal of levodopa and bromocriptine.

1: J Neurosci Nurs. 2005 Jun;37(3):160-2.
Neuroleptic malignant syndrome in a patient with Parkinson's disease: a case study.
Ward C.

Parkinsonism Relat Disord. 2003 Jan;9(3):175-8.
Neuroleptic malignant syndrome-like, or--dopaminergic malignant syndrome--due to levodopa therapy withdrawal. Clinical features in 11 patients.

Neurology Care Line-127PD 2002 Holcombe Blvd., Houston, TX 77030, USA.
Neuroleptic malignant syndrome (NMS) is a potentially lethal condition that has been described in patients with idiopathic Parkinson's disease (PD) after long-term dopaminergic medications are suddenly stopped or moderately decreased …




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