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Comparison of neuroleptic malignant syndrome induced by first- and second-generation antipsychotics
The British Journal of Psychiatry, 07/03/2012
Clinical Article
Trollor JN et al. – The clinical profile of 2G–neuroleptic malignant syndrome (NMS) is largely similar to 1G–NMS, with clozapine–induced NMS being differentiated by the relative lack of rigidity as a feature. Mortality is lower for 2G–NMS.
Methods- The Australian Adverse Drug Reaction Advisory Committee (ADRAC) database was searched to identify individuals with NMS reported between April 1994 and September 2010.
- The clinical characteristics of 208 people with NMS induced by monotherapy with first- or second-generation antipsychotic drugs, as well as presenting features of NMS, were compared.
- The individuals with 2G-NMS were younger and more likely to have a psychotic disorder diagnosis.
- The features of NMS in the two groups were very similar, except that people with 2G-NMS were less likely to present with rigidity or extrapyramidal signs compared with those with 1G-NMS.
- This difference was due to the lower rates of rigidity in those with clozapine-induced NMS.
- Mortality was considerably lower for those with 2G-NMS (3.0%) compared with 1G-NMS (16.3%), and the former were more likely to have received supportive treatment.