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Neuroleptic Malignant Syndrome:     more detail

Neuroleptic Malignant Syndrome and Related Conditions by Stephan C. Mann, Stanley N. Caroff, et all 2003-04 Neuroleptic Malignant Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References by ICON Health Publications, 2004-12-06 Neuroleptic Malignant Syndrome: A Clinical Approach by Gerard Addonizio, Virginia L. Susman, 1991-02 Treatment of Schizophrenia: Schizophrenia, Recovery Model, Chlorpromazine, Neuroleptic Malignant Syndrome, Tardive Dyskinesia, World Health Organization Extrapyramidal and Movement Disorders: Neuroleptic Malignant Syndrome, Essential Tremor, Restless Legs Syndrome, Dystonia Neuroleptic malignant syndrome in a patient with Parkinson's disease: a case study.: An article from: Journal of Neuroscience Nursing by Constance Ward, 2005-06-01 Neuroleptic malignant syndrome: An entry from Thomson Gale's <i>Gale Encyclopedia of Neurological Disorders</i> by Rosalyn, MD Carson-DeWitt, 2005 Atypical neuroleptic malignant syndrome presenting as fever of unknown origin in the elderly.(Case Report): An article from: Southern Medical Journal by Ryan C.W. Hall, Brian Appleby, et all 2005-01-01 Hyperthermic and Hypermetabolic Disorders: Exertional Heat-Stroke, Malignant Hyperthermia and Related Syndromes Drug Induced Movement Disorders Medication-induced movement disorders: An entry from Thomson Gale's <i>Gale Encyclopedia of Mental Disorders</i> by Ajna, Pharm.D. Hamidovic, 2003

lists with details

1. Virtual Hospital: Clinical Psychopharmacology Seminar : Serotonin Syndrome And N
   Serotonin Syndrome and neuroleptic malignant syndrome. Original Author Paul Perry, Ph.D, BCPP Both Serotonin Syndrome (SS) and neuroleptic malignant syndrome (NMS) are rare, but  
   http://www.vh.org/Providers/Conferences/CPS/09.html
   
   Extractions: Peer Review Status: Internally Peer Reviewed INTRODUCTION Both Serotonin Syndrome (SS) and Neuroleptic Malignant Syndrome (NMS) are rare, but potentially life-threatening toxic effects of psychotropic drugs. SS is associated with an excess of serotonin (5HT) usually resulting from increasing the dose of a single serotonergic agonist drug, polypharmacy of serotonic agents, or a pharmacodynamic drug interaction of a monoamine oxidase inhibitor (MAOI) with a serotonin reuptake inhibitor (SRI) (Ciraulo and Shader, 1990). The SS was first reported in the 1950s, but it wasn't until the 1990s that the term serotonin syndrome was used (Keck and Arnold 2000). NMS has been associated with antipsychotic (neuroleptic) drugs and other drugs that affect dopamine (DA) neurotransmission. NMS was first described during early studies of haloperidol in 1960 (Delay et al, 1960). The first report of NMS in English literature was in 1968 (Delay and Deniker, 1968). Since NMS occurs very infrequently, it is extremely difficult to characterize it objectively under controlled conditions. As a result, many uncontrolled reports have been published, sometimes with misleading results. Numerous reviews have been published that provide comprehensive discussions of NMS (Caroff and Mann, 1993; Dickey, 1991; Ebadi et al, 1990; Heiman-Patterson, 1993).

2. NMSIS - Neuroleptic Malignant Syndrome Information Service
   Information about the service as well as the disease itself. Includes research, a hot line and references.  
   http://www.nmsis.org/
   
   Extractions: Welcome to the Neuroleptic Malignant Syndrome Information Service (NMSIS) NMSIS is a not-for-profit organization founded in 1997 by the Malignant Hyperthermia Association of the United States (MHAUS) in collaboration with a group of prominent experts in psychiatry and psychopharmacology. The mission of NMSIS is to serve as an international resource center for educational and research initiatives to promote awareness, improve patient safety, and reduce morbidity and mortality in relation to heat-related disorders. These conditions are uncommon and may be unfamiliar to most practitioners, but can be encountered during the course of routine clinical practice in psychiatry and medicine. NMSIS is available to provide the latest information based on scientific evidence concerning disorders such as Neuroleptic Malignant Syndrome, Serotonin Syndrome, and Malignant Catatonia, Heatstroke, and Hyperthermia associated with drugs of abuse. NMSIS currently offers services, which include a toll free hotline for professionals, educational brochures for patients, families and clinicians, medical articles and literature, a research database, the NMSIS News newsletter, and a spectrum of educational programs and materials.

3. EMedicine - Neuroleptic Malignant Syndrome : Article By Theodore Benzer, MD, PhD
   neuroleptic malignant syndrome The neuroleptic malignant syndrome (NMS) is a rare,but life-threatening, idiosyncratic reaction to a neuroleptic medication.  
   http://www.emedicine.com/emerg/topic339.htm
   
   Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Emergency Medicine Toxicology Last Updated: July 25, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: NMS AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Theodore Benzer, MD, PhD , Chief of Toxicology, Instructor, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School Theodore Benzer, MD, PhD, is a member of the following medical societies: American College of Emergency Physicians Editor(s): Mark S Slabinski, MD , Director, Emergency Services, Southeastern Ohio Regional Medical Center; John T VanDeVoort, PharmD, DABAT , Manager, Clinical Assistant Professor, Pharmacy Department, Regions Hospital; Michael J Burns, MD , Instructor, Department of Emergency Medicine, Harvard University Medical School, Beth Israel Deaconess Medical Center; John Halamka, MD

4. Neuroleptic Malignant Syndrome
   Clinical features, the pathophysiology and treatment.  
   http://www.cmdg.org/Movement_/drug/Neuroleptic_Malignant_Syndrome/neuroleptic_ma
   
   Extractions: Drug Induced Movement Disorders NEUROLEPTIC MALIGNANT SYNDROME Clinical Neuroleptic malignant syndrome is the rarest of the neuroleptic induced movement disorders. It is the most serious and represents a neurologic emergency in most cases. It has now been reported to occur with all drugs that effect the central dopaminergic system (including dopamine agonists and levodopa). There's an isolated report of neuroleptic malignant syndrome in a patient on a trycyclic medication. It is likely an idiosyncratic reaction and patients can, if needed, be given the same agent again without recurrence. It is estimated that 0.5-1% of patients exposed to neuroleptics will develop this syndrome. Most patients will develop it shortly after initial exposure and 90% within two weeks of starting the neuroleptic. It can occur with all the neuroleptics but haldol and trifluperazine are the most common. It has also been seen with clozapine and metoclopramide. The classic triad involves the autonomic nervous system (fever in 100%), the extrapyramidal system (rigidity), and cognitive changes. The two characteristic laboratory findings reported in 75% of cases are a high CPK and leukocytosis. 95% of patients are iron deficient. The CSF is usually normal. The EEG can show diffuse slowing. Other features include tachypnea (78%), diaphoresis (60%), and labile blood pressure (54%). The temperature does not usually exceed 41°C and often peaks before the motor systems become prominent. The most frequent extrapyramidal findings include rigidity (90%) and tremor (56%). Dystonia and chorea have also been reported. Mental status changes occur in 75% of patients. This starts as drowsiness and confusion but can progress to stupor and coma. Other symptoms can include seizures, pyramidal tract findings, ocular flutter, cardiac arrhythmias.

5. NINDS Neuroleptic Malignant Syndrome Information Page
   Compiled by the National Institute of Neurological Disorders and Stroke.  
   http://www.ninds.nih.gov/health_and_medical/disorders/neuroleptic_syndrome.htm
   
   Extractions: Neuroleptic malignant syndrome is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction. In most cases, the disorder develops within the first 2 weeks of treatment with the drug; however, the disorder may develop any time during the therapy period. The syndrome can also occur in people taking anti-Parkinsonism drugs known as dopaminergics if those drugs are discontinued abruptly. Is there any treatment?

6. NORD - National Organization For Rare Disorders, Inc.
   Offers synonyms, a general discussion and further resources.  
   http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Neuroleptic M

7. NEUROLEPTIC MALIGNANT SYNDROME
   neuroleptic malignant syndrome OR NMS K Peripheranl neuropathy as a component of the neuroleptic malignant syndrome Am J Med 1987 Jan 82 (1) 16970  
   http://www.idiom.com/~drjohn/nms.html
   
   Extractions: This catastrophic reaction to dopamine blocking agents, especially HALDOL, more recently RESPIRADOL, (but all the so-called major tranquilizers have been implicated) can lead to death in up to 50% of cases, especially if not immediately recognized. The causative agents must be stopped immediately and never started again. Three Principal Indicators Extreme muscle rigidity - one patient had to have a tenosynovotomy of her Achilles tendons (heel cords cut). Extreme autonomic instability especially rapid heart rate (over 100), temperatures up to 108 (at which point the brain's proteins denature like the white of an egg and there's no return), sweating, high blood pressure (sometimes over 200 systolic), incontinence. Pulmonary emboli may occur. Extreme mental status changes including restlessness, delirium, stupor and coma although patient may be conscious and "locked in." Often mistaken for catatonic schizophrenia (another imaginary "disease of the mind") and treated with even more of the hair of the dog, the anti-psychotic medications and even with electroconvulsive therapy (ECT)!

8. BehaveNet® Clinical Capsule™: Neuroleptic Malignant Syndrome
   DSMIV-TR neuroleptic malignant syndrome. A medication-induced movement disorder, this Gerard Susman, Virginia L. neuroleptic malignant syndrome - A Clinical Approach Hardcover  
   http://www.behavenet.com/capsules/disorders/nms.htm
   
   Extractions: BehaveNet DSM-IV DSM-IV-TR : Neuroleptic Malignant Syndrome A medication-induced movement disorder , this potentially fatal syndrome associated with neuroleptic drugs used in the treatment of mental disorders is characterized by severe muscle rigidity, fever, sweating, hypertension, and delirium sometimes progressing to coma. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. American Psychiatric Association Books and Other Media:

9. EMedicine - Neuroleptic Malignant Syndrome : Article By Darius P Sholevar, MD
   neuroleptic malignant syndrome neuroleptic malignant syndrome (NMS) refers to thecombination of hyperthermia, rigidity, and autonomic dysregulation that can  
   http://www.emedicine.com/med/topic2614.htm
   
   Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Psychiatry Last Updated: November 6, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: NMS, drug-induced movement disorder, lethal catatonia, neuroleptic-induced acute dystonia, neuroleptic-induced akathisia, neuroleptic-induced parkinsonism, neuroleptic-induced tardive dyskinesia, serotonin syndrome, hyperthermia, rigidity, autonomic dysregulation, 3,4-methylenedioxymethamphetamine, MDMA, ecstasy, XTC AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography

10. NMSIS - Neuroleptic Malignant Syndrome Information Service
    neuroleptic malignant syndrome. 2. Caroff SN. The neuroleptic malignant syndrome.Journal of Clinical Psychiatry 1980; 41 7983. 3. Caroff SN, Mann SC.  
    http://www.nmsis.org/general_information.shtml
    
    Extractions: Read Dr. Caroff's article in Current Psychiatry Stephan C. Mann, M.D., Associate Professor of Psychiatry E. Cabrina Campbell, M.D., Assistant Professor of Psychiatry Department of Psychiatry, University of Pennsylvania School of Medicine and the Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania Summary Since the initial description of neuroleptic malignant syndrome (NMS) forty years ago, a wealth of clinical data has accumulated on the manifestations, course, treatment and pathogenesis of this uncommon but serious and potentially lethal drug reaction. Nevertheless, vigilance must be maintained, as this disorder remains obscure to most practicing physicians. Herein, the authors provide a clinical overview of NMS to enhance patient safety and reduce physician liability whenever neuroleptics are administered.

11. NINDS - News And Events
    Sorry! There are no press releases for neuroleptic malignant syndrome.Use your browser s Back button to return to your previous activity.  
    http://www.ninds.nih.gov/health_and_medical/news.htm?url=/health_and_medical/dis

12. EMedicine - Neuroleptic Malignant Syndrome : Article By Darius P Sholevar, MD
    neuroleptic malignant syndrome neuroleptic malignant syndrome (NMS) refers to the combination of hyperthermia, rigidity, and autonomic dysregulation that can occur as a serious complication of  
    http://www.emedicine.com/MED/topic2614.htm
    
    Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Psychiatry Last Updated: November 6, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: NMS, drug-induced movement disorder, lethal catatonia, neuroleptic-induced acute dystonia, neuroleptic-induced akathisia, neuroleptic-induced parkinsonism, neuroleptic-induced tardive dyskinesia, serotonin syndrome, hyperthermia, rigidity, autonomic dysregulation, 3,4-methylenedioxymethamphetamine, MDMA, ecstasy, XTC AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography

13. Neuroleptic Malignant Syndrome - Information / Diagnosis / Treatment / Preventio
    home neurological disorders brain diseases basal ganglia neurolepticmalignant syndrome neuroleptic malignant syndrome. Information  
    http://www.healthcyclopedia.com/neurological-disorders/brain-diseases/basal-gang

14. Psychiatric Times
    neuroleptic malignant syndrome Best Treated as Catatonia. by Max Fink, MD Chicago;May 17. NMSIS (2000), neuroleptic malignant syndrome Information Service.  
    http://www.psychiatrictimes.com/p001128.html

15. Annals Of General Hospital Psychiatry | Full Text | Olanzapine-associated Neurol
    Olanzapineassociated neuroleptic malignant syndrome Is there an overlap with theserotonin syndrome? 1. Caroff SN, Mann SC neuroleptic malignant syndrome.  
    http://www.general-hospital-psychiatry.com/content/2/1/10
    
    Extractions: Background The neuroleptic malignant syndrome is a rare but serious condition mainly associated with antipsychotic medication. There are controversies as to whether "classical" forms of neuroleptic malignant syndrome can occur in patients given atypical antipsychotics. The serotonin syndrome is caused by drug-induced excess of intrasynaptic 5-hydroxytryptamine. The possible relationship between neuroleptic malignant syndrome and serotonin syndrome is at present in the focus of scientific interest. Methods Results The serotonin syndrome clinical features most often reported in cases initially diagnosed as neuroleptic malignant syndrome are: fever (82%), mental status changes (82%) and diaphoresis (47%). Three out of the ten classical serotonin syndrome clinical features were concurrently observed in eleven (65%) patients and four clinical features were observed in seven (41%) patients.

16. Entrez PubMed
    Click here to read Olanzapineassociated neuroleptic malignant syndromeIs there an overlap with the serotonin syndrome? Kontaxakis  
    http://www.general-hospital-psychiatry.com/pubmed/14613516
    
    Extractions: Summary Brief Abstract Citation ASN.1 MEDLINE XML UI List LinkOut Related Articles Cited in Books CancerChrom Links Domain Links 3D Domain Links GEO DataSet Links Gene Links Genome Links GEO Links HomoloGene Links Nucleotide Links OMIM Links PMC Links Cited in PMC PopSet Links Protein Links SNP Links Structure Links UniSTS Links Show: Sort Author Journal Pub Date Text File Clipboard E-mail Order

17. Neuroleptic Malignant Syndrome
    neuroleptic malignant syndrome. What Is It? Neuroleptic MalignantSyndrome (NMS) includes the following collection of symptoms  
    http://easyweb.easynet.co.uk/simplepsych/nms.html
    
    Extractions: Neuroleptic Malignant Syndrome (NMS) includes the following collection of symptoms: Hyperthermia (being too hot) together with some or all of the following The condition is potentially fatal Sometimes this is accompanied by involuntary twitching or tremors in the hands or feet. Antipsychotic (Neuroleptic) Medication No, it is very rare. Firstly the antipsychotic medication must be stopped. The symptoms that the patient shows must then be vigorously treated. If you are interested in going into even more depth, the following book(s), sold by Amazon.co.uk, are recommended by us. Each is followed by a rating for ease of reading (1-3). =Simple and Easy to comprehend.

18. About Neuroleptic Malignant Syndrome
    Information on neuroleptic malignant syndrome. This lifethreatening Whatis neuroleptic malignant syndrome? neuroleptic malignant syndrome  
    http://counsellingresource.com/medications/medication-types/about-nms.html
    
    Extractions: Medication Introduction Psychopharmacology News Discount Drug Controversy Buying Discount Drugs Online ... About 'Withdrawal Symptoms' Medicines by Generic Name: Alprazolam Atomoxetine Bupropion Citalopram ... NIMH Medications Booklet Pt. 2 Many clients opt for Counselling or Therapy to complement their use of medications. This life-threatening neurological disorder is usually caused by an adverse reaction to anti-psychotic, or neuroleptic drugs. Advertising Policy Neuroleptic malignant syndrome is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction. In most cases, the disorder develops within the first 2 weeks of treatment with the drug; however, the disorder may develop any time during the therapy period. The syndrome can also occur in people taking anti-Parkinsonism drugs known as dopaminergics if those drugs are discontinued abruptly. Is there any treatment?

19. Virtual Hospital: Department Of Psychiatry: Psychiatric Emergencies
    Peer Reviewed 2. neuroleptic malignant syndrome This is an idiosyncraticreaction to presumably due to acute dopamine blockade.  
    http://www.vh.org/adult/provider/emergencymedicine/Psychiatry/MedEmergNMS.html
    
    Extractions: Fever, rigidity, diaphoresis, dysphagia, labile blood pressure, Increased pulse rate, altered mental state - delirium. Increased white blood count, increased CPK, SGOT and LDH. Onset is relatively sudden hours to days, which helps distinguish NMS from Lethal Catatonia. Treatment: Obtain medical consultation due to high mortality. Discontinue the antipsychotic immediately.

20. Virtual Hospital: Clinical Psychopharmacology Seminar : Serotonin Syndrome And N
    For Providers. Clinical Psychopharmacology Seminar. Serotonin Syndromeand neuroleptic malignant syndrome. neuroleptic malignant syndrome.  
    http://www.vh.org/adult/provider/psychiatry/CPS/09.html
    
    Extractions: Peer Review Status: Internally Peer Reviewed INTRODUCTION Both Serotonin Syndrome (SS) and Neuroleptic Malignant Syndrome (NMS) are rare, but potentially life-threatening toxic effects of psychotropic drugs. SS is associated with an excess of serotonin (5HT) usually resulting from increasing the dose of a single serotonergic agonist drug, polypharmacy of serotonic agents, or a pharmacodynamic drug interaction of a monoamine oxidase inhibitor (MAOI) with a serotonin reuptake inhibitor (SRI) (Ciraulo and Shader, 1990). The SS was first reported in the 1950s, but it wasn't until the 1990s that the term serotonin syndrome was used (Keck and Arnold 2000). NMS has been associated with antipsychotic (neuroleptic) drugs and other drugs that affect dopamine (DA) neurotransmission. NMS was first described during early studies of haloperidol in 1960 (Delay et al, 1960). The first report of NMS in English literature was in 1968 (Delay and Deniker, 1968). Since NMS occurs very infrequently, it is extremely difficult to characterize it objectively under controlled conditions. As a result, many uncontrolled reports have been published, sometimes with misleading results. Numerous reviews have been published that provide comprehensive discussions of NMS (Caroff and Mann, 1993; Dickey, 1991; Ebadi et al, 1990; Heiman-Patterson, 1993).

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