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Warnings & Precautions
WARNINGS
Neuroleptic Malignant Syndrome ( NMS) A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome ( NMS) has been reported in association with antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability ( irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia) . Additional signs may include elevated creatinine phosphokinase, myoglobinuria ( rhabdomyolysis) , and acute renal failure. Text Continues Below
The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases in which the clinical presentation includes both serious medical illness ( e. g. , pneumonia, systemic infection, etc. ) and untreated or nadequately treated extrapyramidal signs and symptoms ( EPS) . Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. The management of NMS should include: ( 1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy; ( 2) intensive symptomatic treatment and medical monitoring; and ( 3) treatment of any concomitant serious medical problems for which specific treatments are available. There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS. If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered. The patient should be carefully monitored, since recurrences of NMS have been reported. Tardive Dyskinesia A syndrome of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs. Although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to rely upon prevalence estimates to predict, at the inception of antipsychotic treatment, which patients are likely to develop the syndrome. Whether antipsychotic drug products differ in their potential to cause tardive dyskinesia is unknown. Page: 1 | 2 | 3 | 4 | 5 | Next >>
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