Sachdev P, Mason C, Hadzi-Pavlovic D
School of Psychiatry, University of New South Wales, Australia.
Am J Psychiatry. 1997 Aug;154(8):1156-8. doi: 10.1176/ajp.154.8.1156.
The authors performed a case-control study of neuroleptic malignant syndrome to identify potential risk factors.
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.
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.
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.
作者进行了一项关于抗精神病药恶性综合征的病例对照研究，以确定潜在的风险因素。
25例抗精神病药恶性综合征患者与50名对照受试者在年龄、性别、原发性精神科诊断及入院时间方面进行匹配。两名研究人员独立查阅所有受试者的记录，以获取关于假定风险因素的信息。在对两组进行探索性直接比较之后，进行条件逻辑回归分析。
抗精神病药恶性综合征患者在发生抗精神病药恶性综合征之前更有可能出现烦躁或脱水，常常需要约束或隔离，并且在住院后不久接受了更大剂量的抗精神病药物。既往接受电休克治疗会增加易感性。
在急性精神病的治疗中，通过避免短期内使用大剂量抗精神病药物，并充分关注患者的水合作用和电解质状况，可降低抗精神病药恶性综合征的患病率。
