From the Guidelines
Neuroleptic Malignant Syndrome (NMS) and Extrapyramidal (EP) reactions can be described to laypeople as severe and potentially life-threatening side effects of certain medications, including antipsychotics, which can cause muscle stiffness, tremors, and changes in mental status.
Key Points
- Extrapyramidal side effects include symptoms such as muscle stiffness, tremors, and restlessness, which can occur when taking antipsychotic medications, especially typical antipsychotics 1.
- Neuroleptic Malignant Syndrome (NMS) is a rare but life-threatening condition that can occur when taking antipsychotic medications, characterized by symptoms such as high fever, muscle stiffness, and changes in mental status 1.
- Atypical antipsychotics, such as risperidone and olanzapine, are generally better tolerated than typical antipsychotics and have a lower risk of extrapyramidal side effects, but can still cause these symptoms in some cases 1.
- Clozapine, an atypical antipsychotic, has a higher risk of side effects, including seizures and agranulocytosis, and requires regular blood cell count monitoring 1.
Important Considerations
- Monitoring and management of extrapyramidal side effects and NMS are crucial to prevent long-term damage and improve treatment outcomes 1.
- Dose and titration of antipsychotic medications should be carefully managed to minimize the risk of side effects 1.
- Patient education and awareness of potential side effects are essential to ensure early detection and treatment of extrapyramidal side effects and NMS 1.
From the Research
Layperson Descriptions of Neuroleptic Malignant Syndrome (NMS)
- NMS is a rare but potentially lethal form of neuroleptic drug-induced hyperthermia, altered level of consciousness, extrapyramidal effects, autonomic instability, and muscle rigidity 2
- It is characterized by hyperthermia, extrapyramidal symptoms, altered consciousness, and autonomic dysfunction 3, 4
- NMS can be caused by the use of neuroleptics, as well as non-neuroleptic agents that block central dopamine pathways 4
- Presenting features include extrapyramidal symptoms, altered mental consciousness, autonomic dysfunction, and hyperthermia 5
Layperson Descriptions of Extrapyramidal (EP) Reactions
- Extrapyramidal reactions are a type of side effect associated with neuroleptic medication, which can include symptoms such as muscle rigidity, tremor, and altered mental status 3, 6
- EP reactions can be a precursor to NMS, and may be characterized by extrapyramidal disturbances, such as rigidity and tremor 3
- In some cases, a "benign" extrapyramidal side effect can mask a life-threatening NMS 6