Abstract

Introduction: Neuroleptic malignant syndrome (NMS) is a life-threatening complication that can occur anytime during antipsychotic treatment. In the present assessment the incidence and clinical profile of NMS have been probed among a sample of non-western psychiatric inpatients and compared with the available data in literature regarding prevalence and other associated clinical physiognomies.

Methods: As a retrospective, record based evaluation, all cases that had been diagnosed absolutely as NMS during the last sixty-two months, after ruling out other imaginable differential diagnosis, like encephalitis, meningitis and serotonin syndrome, had been included in the present investigation. Clinical diagnosis, as well, was based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM- 5). Appraisal of independent variables had been analyzed by means of Compression of proportions. Statistical significance as well, had been defined as p value≤0.05.

Results: Among 19814 psychiatric patients hospitalized in razi psychiatric hospital, during a sixty-two months’ period (April of 2013-August 2018), eighteen cases (N=18) had been referred to Intensive Care Unit (ICU) with diagnosis of NMS. The most prevalent symptom was fever, which was present in 100% of cases and was significantly more frequent in comparison with. No significant difference was evident between the remaining symptoms as regards incidence. Also, there was not any significant difference between the first generation versus second generation antipsychotics. NMS was significantly more prevalent among patients suffering from schizophrenia, and amongst male patients. Similarly, it was significantly more widespread amid 18-65 years old age-group, especially age group of 30-39. Fatality was limited to only one patient.

Conclusion: While no significant difference was evident between first generation as opposed to second generation antipsychotics, NMS was significantly more prevalent among young and male patients suffering from schizophrenia.

Keywords: Neuroleptic malignant syndrome; Typical antipsychotic; Atypical antipsychotic; Schizophrenia