How Often Do You See Neuroleptic Malignant Syndrome?
Question by Olga: How often do you see Neuroleptic Malignant Syndrome?
I’ve been working as a Psychiatric RN for a number of years now and I have never seen a single case of NMS.
How often do we still see NMS in current times?
Best answer:
Answer by rb43081
It is certainly believed that the risk/incidence of NMS (and all acute extrapyramidal syndromes) should be decreasing with the increased use of newer drugs. On the other hand, ALL drugs are being used more often, perhaps for longer periods of time and possibly, in patients of greater risk (older, for example).
Take a look at this:
Mov Disord. 2006 May;21(5):589-98.
Epidemiology of tardive dyskinesia: is risk declining with modern antipsychotics?
Tarsy D, Baldessarini RJ.
Department of Neurology, Harvard Medical School, and Beth Israel-Deaconess Medical Center, Boston, Massachusetts 02215, USA. [email protected]
Abstract
Second-generation antipsychotic drugs (APDs), including aripiprazole, clozapine, olanzapine, risperidone, quetiapine, and ziprasidone dominate outpatient and inpatient clinical practice, having largely displaced the older neuroleptics. Modern APDs have relatively low risk for acute extrapyramidal syndromes characteristic of older neuroleptics, particularly acute dystonia and Parkinsonism, with variable risks of akathisia and the rare neuroleptic malignant syndrome. Anticipated reduction in risk of tardive dyskinesia (TD) is less well documented. Nearly 50 years after initial reports on TD, it is appropriate to reexamine the epidemiology of this potentially severe late adverse effect of long-term APD treatment in light of current research and practice. We compared recent estimates of incidence and prevalence of TD identified with some modern APDs to the epidemiology of TD in the earlier neuroleptic era. Such comparisons are confounded by complex modern APD regimens, uncommon exposure limited to a single modern APD, effects of previous exposure to typical neuroleptics, and neurological assessments that are rarely prospective or systematic. Available evidence suggests that the risk of TD may be declining, but longitudinal studies of patients never treated with traditional neuroleptics and exposed to only a single modern APD are required to quantify TD risks with specific drugs. Long-term use of APDs should continue to be based on research-supported indications, with regular specific examination for emerging TD.
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Rex, a physician, in the midwest
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