Nonneurokptic Etiologies of Extrapyramidal Symptoms

An agitated young man

“…5 Neuroleptic malignant syndrome is not only caused by antipsychotics but has also been described after withdrawal of antiparkinsonian drugs, with lithium, tricyclic antidepressants and very rarely other drugs including carbamazepine, and oral contraceptives. 6 Although it is most commonly associated with typical antipsychotics, it occurs in less than 1% of patients taking such drugs. 3 Estimates of the incidence of neuroleptic malignant syndrome vary between 0.02% and 0.2% per year, 3 7 8 and it is more common in men, particularly after agitation and when using high potency antipsychotic drugs in rapid tranquillisation situations.…”