Neuroleptic Malignant Syndrome: Review of Response to Therapy

doi:10.1001/archinte.1989.00390090009002

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Vol. 149 No. 9, September 1989

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Neuroleptic Malignant Syndrome

Review of Response to Therapy

Mark R. Rosenberg, MD; Marylee Green, MD

Arch Intern Med. 1989;149(9):1927-1931.

Abstract

• The purpose of this study was to evaluate options availablefor the treatment of neuroleptic malignant syndrome. We conducteda computer search of English-language literature using a Medlinedatabase and review of bibliographies of identified articles.Sixty-four case reports containing sufficient data about patientsdemographics and clinical response to therapy to allow evaluationwere combined with three previously unreported cases. The meantime to clinical response was 6.8 days when supportive measuresalone were used in the treatment of neuroleptic malignant syndrome.The addition of dantrolene (response time, 1.15 days) or bromocriptine(response time, 1.03 days) significantly shortened the timeto clinical response. We conclude that the addition of eitherdantrolene or bromocriptine to conservative measures decreasesthe time to clinical response. A randomized trial would addresspotential case selection biases.

(Arch Intern Med. 1989;149:1927-1931)

Author Affiliations

From the Department of Medical Education, Providence Medical Center, Portland, Ore (Drs Rosenberg and Green), and the Department of Medicine, Oregon Health Sciences University, Portland (Dr Rosenberg).

Footnotes

Accepted for publication March 31, 1989.

Reprint requests to Providence Medical Center, 4805 NE GlisanSt, Portland, OR 97213-2967 (Dr Rosenberg).

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