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Rare Diseases 2023

Síndrome neuroléoptic malignancy: what é, symptoms and how to treat

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Síndrome neuroléoptic malignancy: what é, symptoms and how to treat
Síndrome neuroléoptic malignancy: what é, symptoms and how to treat

Neuroleptic malignant syndrome is a severe reaction to the use of neuroleptic drugs such as haloperidol, olanzapine or chlorpromazine and antiemetics such as metoclopramide, domperidone or promethazine, for example, which can lead to dopamine blockade. Although it is rare, this syndrome can be life-threatening if treatment is not started quickly and, therefore, it is necessary to be aware of possible symptoms that arise after the use of this type of medication.

Thus, when signs such as fever above 39º C, difficulty moving the limbs or extreme agitation appear, after using this type of medication, it is recommended to go quickly to the hospital, to evaluate the problem, confirm the diagnosis and start the most appropriate treatment.

Main symptoms

The most common symptoms of neuroleptic malignant syndrome include:

  • High fever, above 39ºC;
  • Feeling short of breath;
  • Muscle stiffness;
  • Irregular and fast heartbeat;
  • Difficulty moving arms and legs;
  • Mental changes such as confusion, agitation, or fainting;
  • Increased perspiration;
  • Muscle stiffness, accompanied by tremors;
  • Shincter incontinence;
  • Sudden changes in blood pressure.

These symptoms can occur in anyone who is being treated with neuroleptic drugs, but most often occur during the first two weeks of treatment.

At the hospital, in addition to evaluating the symptoms, the doctor may also order some tests, such as blood tests and/or kidney and liver function tests, in order to reach the diagnosis more easily.

Who is most at risk

Although it is not possible to predict who may suffer from neuroleptic malignant syndrome, it is known that people who are usually agitated or who take very high doses of neuroleptic drugs are more likely to develop the syndrome.

How the treatment is done

Treatment is usually done while in hospital to assess the evolution of symptoms and administer medication directly into the vein. The most common forms of treatment include:

  • Suspension of the medication that gave rise to the syndrome;
  • Use of activated charcoal: helps reduce drug adsorption if ingestion has taken place recently;
  • Serum directly into the vein: maintains adequate hydration and regulates the level of nutrients in the body;
  • Muscle relaxing drugs, such as Dantrolene: relieves muscle stiffness caused by nervous system excitation;
  • Antipyretic drugs, such as paracetamol or dipyrone: lower body temperature and fight fever.

In addition, the doctor can also use other techniques, including electroconvulsive therapy or plasmapheresis, for example.

Depending on the time of development of the syndrome, complications such as renal failure or a marked reduction in the level of oxygen in the body, for example, may arise, which need to be treated. See how kidney failure is treated.

Possible complications

When neuroleptic malignant syndrome is not treated properly or treatment is not started in time, various types of complications such as renal failure, seizures, pneumonia, liver failure or pulmonary embolism can arise. In the most severe cases, respiratory and cardiac arrest can still occur.

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