Neuroleptic malignant syndrome (NMS)
- Stop dopamine-blocking drug immediately
- ICU supportive care: cooling, fluids, complications
- Benzodiazepines may help mild/catatonic features
- Dantrolene or bromocriptine for severe cases
- ECT is effective for refractory/catatonic NMS
- Rechallenge only after recovery with cautious strategy
Use at a glance
- Stop dopamine-blocking drug immediately
Escalation / refractory disease
- ECT is effective for refractory/catatonic NMS
Later-line options
- Benzodiazepines may help mild/catatonic features
- Dantrolene or bromocriptine for severe cases
- Rechallenge only after recovery with cautious strategy
Practical pearls
- ICU supportive care: cooling, fluids, complications
Self-check
- What is stopped immediately in NMS?
Dopamine-blocking drug. - What is effective for refractory/catatonic NMS?
ECT.
Drugs used for this (2)
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