Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- history of exposure to antipsychotic medications
- history of abrupt withdrawal of dopaminergic drugs
- altered mental status
- muscle rigidity
- autonomic dysfunction
- hyperthermia
Fatores de risco
- exposure to antipsychotic medications
- structural brain abnormality
- abrupt withdrawal of dopaminergic drugs
- older age
- preexisting agitation
- akathisia
- male sex
- iron deficiency
- catatonia
- preexisting dehydration
- exposure to other dopamine antagonists
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC
- serum creatine kinase
- basic metabolic panel
- brain CT scan
- brain MRI
- myoglobin levels and urinalysis
- urine culture
- blood culture
- lumbar puncture
- toxicology screen
- chest x-ray
Investigações a serem consideradas
- serum iron
- electroencephalogram
Algoritmo de tratamento
initial episode
recurrence
Colaboradores
Consultores especialistas
Ronald J. Gurrera, MD
Associate Professor
Harvard Medical School
Boston
MA
Declarações
RJG declares that he has no competing interests.
Agradecimentos
Dr Ronald J. Gurrera would like to gratefully acknowledge Dr Peter F. Buckley, a previous contributor to this topic.
Declarações
PFB is on the advisory board (a voluntary, uncompensated role) of the Neuroleptic Malignant Syndrome Information Service. He is also a consultant to Janssen Pharmaceutica and the National Institute of Mental Health (NIMH). He is conducting or has recently conducted research with funding support from AstraZeneca, NIMH, Janssen Pharmaceutica, Pfizer, Solvay, and Wyeth. Previous consultancy and research support has been from Abbott, Alamo Pharmaceuticals, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Lundbeck, Janssen Pharmaceutica, Merck, NIMH, Roche Diagnostics, Pfizer, Solvay, and Wyeth. PFB has no patents or stock in any company. He is an author of several references cited in this topic. PFB is a co-investigator on a study also involving Dr John Lauriello and Dr Daniel R. Wilson, who were reviewers for this topic.
Revisores
Alison Haddow, MBBS
Consultant Psychiatrist
Honorary Senior Clinical Lecturer
Royal Cornhill Hospital
Aberdeen
UK
Declarações
AH declares that she has no competing interests.
John Lauriello, MD
Professor and Chair
Department of Psychiatry
University of Missouri-Columbia
Columbia
MO
Declarações
JL declares that he has no competing interests.
Ganesh Gopalakrishna, MD
Assistant Professor
Department of Psychiatry
University of Missouri-Columbia
Columbia
MO
Declarações
GG declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Sepsis
- Status epilepticus
- Drug misuse/overdose
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Neuroleptic malignant syndrome
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