Am J Psychiatry 1997; 154:1156-1158
Copyright © 1997 by American Psychiatric Association
Case-control study of neuroleptic malignant syndrome
P Sachdev, C Mason and D Hadzi-Pavlovic
School of Psychiatry, University of New South Wales, Australia. P.Sachdev@unsw.edu.au
OBJECTIVE: The authors performed a case-control study of neuroleptic
malignant syndrome to identify potential risk factors. METHOD: Twenty- five
patients with neuroleptic malignant syndrome were matched with 50
comparison subjects on age, sex, primary psychiatric diagnosis, and time of
admission to the hospital. The records of all subjects were reviewed
independently by two researchers for information on postulated risk
factors. Exploratory direct comparisons of the two groups were followed by
a conditional logistic regression analysis. RESULTS: Patients with
neuroleptic malignant syndrome were more likely to be agitated or
dehydrated before the development of neuroleptic malignant syndrome, often
needed restraint or seclusion, and received larger doses of neuroleptics
soon after hospitalization. Previous treatment with ECT increased
vulnerability. CONCLUSIONS: The prevalence of neuroleptic malignant
syndrome may be reduced by avoiding large doses of neuroleptics over short
periods in the management of acute psychosis and by paying adequate
attention to the patient's hydration and electrolyte status.
