What is Neuroleptic Malignant Syndrome?

Patients with neuroleptic malignant syndrome are put into a life threatening condition and neurological disorder. It is most often caused by an adverse reaction to antipsychotic and neuroleptic drugs. It can cause a wide range of side effects and can be fatal if not treated properly. The treatments can be simple or well drawn out. It is very important that those who have had neuroleptic malignant syndrome episodes to seek treatment to prevent serious damages to the body. Seeing a doctor and asking about how to treat and manage the disorder is important.

Who Can Have Neuroleptic Malignant Syndrome?

Anyone may have neuroleptic malignant syndrome and it is impossible to tell who can have it. It is not known if it can be genetically inherited as the symptoms can happen to nearly everyone, even if they have been using the medicines that cause it for quite some time. The symptoms are often immediate and can severely impact the body, causing death, especially if the person takes too high of a dose than recommended. The condition is thought to be very rare as it occurs in a small fraction of those who take the neuroleptic and antipsychotic drugs.

The Symptoms and Complications of Neuroleptic Malignant Syndrome

Muscular Cramps – Cramping of the muscles are common with neuroleptic malignant syndrome as the brain will often send signals that are very confused to the muscles and cause them to over contract. The changes in body chemistry that are possible with neuroleptic malignant syndrome can also cause cramps to occur in otherwise normal conditions.

Muscle Rigidity – When the body is in chaos from neuroleptic malignant syndrome, the muscles can become very rigid and cause them to heat up very quickly from stress to the muscle tissues. This usually comes with the extreme body cramps that are possible with neuroleptic malignant syndrome through chemical imbalances in the body. This symptom may be able to be alleviated with a muscle relaxant.

Fever – The elevated body temperatures over 100 degrees F are possible with neuroleptic malignant syndrome and may be uncontrollable due to the chemical imbalances in the body. The inability to control the processes that cause control of body temperatures may be culprit to the fevers that are present in people with neuroleptic malignant syndrome.

Diaphoresis – This condition is much more commonly known as sweat shock syndrome and is very common in neuroleptic malignant syndrome sufferers. The body begins to sweat uncontrollably and can even cause dehydration and multiple problems that come with sweating so much. Usually this is a response to the body to attempt to take out toxins in the body much more quickly than filtering through the kidneys to pass as urine.

Encephalopathy – The global disorder or disease of the brain that causes severe dysfunction. Can cause convulsions and other unpleasant effects that can lead towards harm to the body as well as secondary symptoms such as a stroke or heart attack would produce if the person survives the episode. This can be very difficult to deal with, especially if the condition allows for infections to occur in the brain.

Autonomic Instability – This is caused by neuroleptic malignant syndrome when the brain is unable to control the body. This can lead to not breathing, rapid uncontrollable heart beat, vomiting, high fevers, muscle strain, incontinence and many other problems. This is a very serious condition that must be monitored and treated if possible at a hospital so that the sufferer is able to get the treatment they need to improve their condition.

Cognitive Changes – A person that is suffering from neuroleptic malignant syndrome may be host to several cognitive changes. These changes can be anything from losing senses to experiencing hypersensitivity as well as a large list of other neurological disorders/effects. This is one reason why doctors misdiagnose patients with neuroleptic malignant syndrome as they look like they are simply suffering from another mental illness.

Delirium – The inability to focus and cope with reality is possible through the effects of neuroleptic malignant syndrome. A person can become delirious and suffer hallucinations and many other delusions. The problem with this is that it can become very dangerous for the sufferer and they may even do very dangerous things to themselves and others.

Elevated CPK Levels – This is Creatine Phosphokinase release in the blood system which is due to muscle breakdown and metabolic acidosis. Another possibility is hypertensive emergency where the blood pressure is so highly elevated that the person can pass out and even go into coma or simply die from the inability of the heart to handle these conditions.

Coma – Neuroleptic malignant syndrome can lead to comas in many ways. One is by chemical imbalance of the body forcing the perpetual unconsciousness. The coma can also be brought on by seizures or other effects that are possible with neuroleptic malignant syndrome as the head may be severely damaged during an episode.

Death – Sudden death can be caused by neuroleptic malignant syndrome as the body cannot deal with a chemical imbalance that is too toxic to allow the body to run properly to support life. This is most often a result of not getting appropriate treatment for the person who suffers from neuroleptic malignant syndrome. Symptoms like coma can cause death if the person is reclusive and lives by them self without any help.

Risk Factors for Neuroleptic Malignant Syndrome

Many people could be at risk for neuroleptic malignant syndrome and these are the factors that can trigger the complications with the disorder:

Age – People under the age of forty are shown to have many more problems with neuroleptic malignant syndrome. This is probably due to the fact that more neroleptic and antipsychotic drugs are administered at much younger age than they used to before. Those over 40 have not shown as many cases of neuroleptic malignant syndrome.

Genetics – It is not determined whether that genetic makeup really plays a part, but there have been cases where mothers and their daughters were affected by neuroleptic malignant syndrome when taking similar drugs. This has not been studied on a large enough scale to conclude that it is genetic and to what extent.

Men – The male patients have shown a much higher chance of suffering from neuroleptic malignant syndrome as compared to females. Especially young men in their teens to middle age time periods of their lives are most susceptible to the disorder.

Women – Most of the women that suffer from neuroleptic malignant syndrome get it after post partum. This may also be due to the need to control depression and other neurological disorders that occur with post partum. Some younger girls have also been shown to have neuroleptic malignant syndrome when administered neuroleptic and antipsychotic drugs.

High Potency Drug Therapy – When doctors and specialists prescribe high or potent doses of drugs to deal with neurological disorders, the body may react much differently to the pills. The most important thing about these drugs is that they need to be administered at a tiered system. A sudden crash in the body due to a large involvement of these drugs can cause the neuroleptic malignant syndrome to flare.

Treatments for Neuroleptic Malignant Syndrome

The treatment options are limited aside from helping to improve the condition of certain symptoms. The treatments that are needed may not always be offered to the sufferers of neuroleptic malignant syndrome as the doctors may misdiagnose the disease (as it usually takes an expert’s opinion to determine that neuroleptic malignant syndrome is the cause).

The most common treatment is to simply take the patient off of the medications that cause negative interactions for those who suffer from neuroleptic malignant syndrome. They can find an alternative medicinal treatment to help with their needs if it is important enough to be unavoidable for treatment.

Possible reductions in the amount of the drugs that cause the neuroleptic malignant syndrome flare ups may be done to help reduce the effects. This is not always beneficial as some people are very hyper-reactive to certain drug interactions. This can occur even in very small doses of certain drugs.

Since hyperthermia is usually a big part of neuroleptic malignant syndrome, the main thing that needs to be treated during the neuroleptic malignant syndrome flare up is the body temperature with drugs like dantrolene. Aggressive hydration of the body may be required to help prevent kidney damage due to the high CPK levels in the blood stream by increasing the ratio of water to CPK proteins. If caught early enough, damages to the body can be prevented, but about 10 percent of the cases will result in death.

The Outlook for Patients with Neuroleptic Malignant Syndrome

People that survive neuroleptic malignant syndrome can expect to live with little complications if the condition is treated early on. About 10 percent of the people do die, but this is a decrease of about 20 percent over the past two decades because of increased treatment and management of the disorder. Introduction of the chemical or drug that caused the neuroleptic malignant syndrome flare may cause it to recur. Most cases do not have this effect though and some people can even use the drug with no consequences once they recover. It is very important to make a decision that is best for the individual patient regarding the reintroduction of the medicine that caused the condition to flare up.

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