High-dose vitamin E plus vitamin B6 treatment of risperidone-related neuroleptic malignant syndrome

Dursun, Serdar; Oluboka, O. J.; Devarajan, S.; Kutcher, Stan

doi:10.1177/026988119801200214

Cited by 16 publications

(3 citation statements)

References 12 publications

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“…Evidence exists that some of the neuroleptics currently in use can release free radicals and these can precipitate NMS 121,122. It would thus be logical to consider treating the syndrome with antioxidants, at least as adjuvant remedies 123. One interesting issue concerning valproate is that it can precipitate NMS,124 but can also be used in treatment of this syndrome 125.…”

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Oruch¹,

Pryme²,

Engelsen³

et al. 2017

NDT

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Neuroleptic malignant syndrome is an unpredictable iatrogenic neurologic emergency condition, mainly arising as an idiosyncratic reaction to antipsychotic agent use. It is characterized by distinctive clinical features including a change in mental status, generalized rigidity, hyperpyrexia, and dysautonomia. It can be lethal if not diagnosed and treated properly. Mortality and morbidity attributed to this syndrome have recently declined markedly due to greater awareness, earlier diagnosis, and intensive care intervention. In most cases, the syndrome occurs as a result of a rapid increase in a dose of neuroleptic, especially one of the long-acting ones. Pathophysiology behind this syndrome is attributed to a dopamine receptor blockade inside the neurons rendered by the offending drug and excessive calcium release from the sarcoplasmic reticulum of skeletal myocytes. Laboratory tests, although not diagnostic, may assist in assessing the severity of the syndrome and also the consequent complications. The syndrome has been described in all age groups and occurs more in males than in females. Genetics appears to be central regarding the etiology of the syndrome. Stopping the use of the offending agent, cold intravenous fluids, and removal of the causative agent and its possible active metabolites is the cornerstone of treatment. Periodic observation of psychotic patients recently started on antipsychotic medications, especially those being treated with depot preparations, may aid to an early diagnosis of the syndrome and lead to early treatment.

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Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Neuroleptic malignant syndrome: an easily overlooked neurologic emergency

Oruch¹,

Pryme²,

Engelsen³

et al. 2017

NDT

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show abstract

“…Other more speculative drug treatments that have been utilized for NMS include pancuronium [119], levodopa [100], apomorphine and lisuride [3], and vitamin E [120]. Iron supplementation is proposed as having a protective effect; however, this has not been well supported [3].…”

Section: Specific Treatmentsmentioning

confidence: 99%

Neuroleptic Malignant Syndrome

Mehndiratta

Spolter

Igboeli

et al. 2013

Neuromuscular Disorders in Clinical Practice

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“…Mais freqüente com neurolépticos de alta potência, sendo proposta a redução de dose, ou troca por ANG. Dursun 17 propõe tratamento com vitaminas E e B6, porém com poucas confirmações de seus achados. No caso de aumento importante de prolactina, a redução da dose do antipsicótico demonstrou melhora somente nos homens.…”

Section: Amenorréiaunclassified