What is NMS in psychiatry?

What is NMS in psychiatry?

INTRODUCTION Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency associated with the use of antipsychotic (neuroleptic) agents and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia.

What are symptoms of NMS?

Symptoms of neuroleptic malignant syndrome usually include very high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure.

Why is NMS a medical emergency?

Neuroleptic malignant syndrome (NMS) is a lethal medical emergency associated with the use of neuroleptic agents and antiemetics that is characterized by a typical clinical syndrome of hyperthermia, rigidity, mental status alteration, and dysautonomia.

What is NMS a side effect of?

Neuroleptic malignant syndrome (NMS) is a rare reaction to antipsychotic drugs that treat schizophrenia, bipolar disorder, and other mental health conditions. It affects the nervous system and causes symptoms like a high fever and muscle stiffness.

What is the treatment for NMS?

In more severe cases of NMS, empiric pharmacologic therapy is typically tried. The two most frequently used medications are bromocriptine mesylate, a dopamine agonist, and dantrolene sodium, a muscle relaxant that works by inhibiting calcium release from the sarcoplasmic reticulum.

How do you test for NMS?

No laboratory test result is diagnostic for neuroleptic malignant syndrome (NMS)….Approach Considerations

1. Complete blood count (CBC)
2. Blood cultures.
3. Liver function tests (LFTs)
4. Blood urea nitrogen (BUN) and creatinine levels.
5. Calcium and phosphate levels.
6. Creatine kinase (CK) level.
7. Serum iron level.
8. Urine myoglobin level.

How do you treat NMS?

How can you prevent NMS?

The most important aspect of treatment is prevention. This includes reducing risk factors (e.g. dehydration, agitation and exhaustion), early recognition of suspected cases and prompt discontinuation of the offending agent.

Is TD irreversible?

Tardive dyskinesias (TD) are persistent and often irreversible involuntary movements that occur following prolonged neuroleptic therapy (Sethi, 2004).

Is NMS reversible?

The mortality rate of NMS is estimated to be as high as 20% and the usual cause of death is due to acute renal failure. Fortunately, with early recognition and intervention, it is usually reversible without any serious complications.

What medications can cause NMS?

The primary trigger of NMS is dopamine receptor blockade and the standard causative agent is an antipsychotic. Potent typical neuroleptics such as haloperidol, fluphenazine, chlorpromazine, trifluoperazine, and prochlorperazine have been most frequently associated with NMS and thought to confer the greatest risk.

How is neuroleptic malignant syndrome ( NMS ) defined?

Abstract Neuroleptic malignant syndrome (NMS) is a life-threatening idiosyncratic reaction to antipsychotic drugs characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction.

What does NMS stand for in medical category?

Abbreviation: NMS, neuroleptic malignant syndrome.

What are the signs and symptoms of NMS?

Signs of autonomic nervous system instability that frequently accompany NMS include labile blood pressure, tachypnea, tachycardia, sialorrhea, diaphoresis, flushing, skin pallor, and incontinence. Once symptoms appear, progression can be rapid and can reach peak intensity in as little as 3 days.

What is the next step in the management of NMS?

The next key step in the management of NMS is the initiation of supportive medical therapy. Aggressive hydration is often required, especially if highly elevated CPK levels threaten to damage the kidneys, and treatment of hyperthermia with cooling blankets or ice packs to the axillae and groin may be needed.