Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: A case-control study
Clinical and pharmacologic risk factors for neuroleptic malignant syndrome: A case-control study
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DOI：
10.1016/s0006-3223(97)00530-1
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发表时间：
1998-10-15
影响因子：
10.6
通讯作者：
Dell'Atti, M
中科院分区：
文献类型：
--
作者：
Berardi, D;Amore, M;Dell'Atti, M
背景：神经安定药恶性综合征的药理学和临床危险因素已被提出。在一项病例对照研究中，高剂量、低剂量增加和肠外给药被确定为危险因素；然而，关于潜在临床危险因素的数据有限。方法：为探讨潜在的临床危险因素，黑麦进行病例对照研究，将12例患者与24例对照组进行比较，所有患者均在本中心接受抗精神病药物治疗。除了检查先前假定的药理学危险因素外，我们还评估了精神运动性躁动、精神错乱、精神紊乱和紧张症的存在。结果：在精神运动性躁动、精神错乱、精神紊乱、精神紧张症、平均和最大抗精神病药物剂量、静脉注射抗精神病药物、发作后5天内抗精神病药物剂量增加、抗精神病药物剂量较初始剂量增加、神经系外征象等方面，病例与对照组存在显著差异。结论：本研究表明，除药理学危险因素和锥体外系体征（包括静坐症）外，精神运动性躁动、精神错乱、行为紊乱和紧张症等精神病理特征可能是抗精神病药恶性综合征的危险因素。在临床实践中，在对精神运动性躁动、精神错乱和/或精神紊乱的患者进行抗精神病药物治疗时，需要仔细监测抗精神病药物恶性综合征的前驱症状，而在出现紧张症时应避免使用这些药物。生物精神病学1998；[44]中华医学会精神病学分会。
Background: Pharmacologic and clinical risk factors for neuroleptic malignant syndrome have been suggested. High neuroleptic dose, vapid dosage increase, and parenteral administration were identified as risk factors in a case-control study; however, there are limited data regarding potential clinical risk factors.Methods: To examine potential clinical risk factors, rye conducted a case-control study, comparing 12 cases to 24 controls, all treated with neuroleptics at our center. In addition To examining previously postulated pharmacologic risk factors, we also assessed for presence of psychomotor agitation, confusion, disorganization, and catatonia.Results: Significant differences were found between cases and controls for psychomotor agitation, confusion, disorganization, catatonia, mean and maximum neuroleptic dose, parenteral neuroleptic injections, neuroleptic nose increase within 5 days of the episode, magnitude of neuroleptic dose increase from initial dose, and extrapy-ramidal signs.Conclusions: This study demonstrated that psychopathological features such as psychomotor agitation, confusion, disorganized behavior and catatonia may be risk factors for the neuroleptic malignant syndrome, in addition to pharmacologic risk factors and extrapyramidal signs, including akathisia. In clinical practice, careful monitoring for prodromal signs of neuroleptic malignant syndrome is required during neuroleptic treatment of patients with psychomotor agitation, confusion, and/or disorganization, while in the presence of catatonia these drugs should be avoided. Biol Psychiatry 1998;44: 748-754 (C) 1998 Society of Biological Psychiatry.