Hasan S, Buckley P
Department of Psychiatry, Case Western Reserve University and University Hospitals of Cleveland, OH 44106, USA.
Am J Psychiatry. 1998 Aug;155(8):1113-6. doi: 10.1176/ajp.155.8.1113.
The authors' goal was to analyze reported cases of neuroleptic malignant syndrome in patients given clozapine and risperidone.
They assessed 19 cases of clozapine-induced neuroleptic malignant syndrome and 13 cases of risperidone-induced neuroleptic malignant syndrome against three criteria sets and against extent of exclusionary workup and then designated them as high or low probability of being neuroleptic malignant syndrome.
Nine of the 19 cases of clozapine-related neuroleptic malignant syndrome and eight of the 13 cases of risperidone-related neuroleptic malignant syndrome were designated as having high probability of being neuroleptic malignant syndrome. The remainder were designated as having low probability because presentations were not linked to treatment or failed to meet criteria for the syndrome.
Neuroleptic malignant syndrome can occur in patients given atypical antipsychotics and resembles "classical" neuroleptic malignant syndrome. However, side effect profiles overlap considerably with neuroleptic malignant syndrome criteria, and atypical antipsychotics may cause neurotoxicities unrelated to (but misattributed as) neuroleptic malignant syndrome. Insufficient evidence exists for "atypical" neuroleptic malignant syndrome with novel antipsychotics.
作者的目标是分析服用氯氮平和利培酮的患者中报告的神经阻滞剂恶性综合征病例。
他们根据三组标准以及排除性检查的程度，评估了19例氯氮平诱发的神经阻滞剂恶性综合征病例和13例利培酮诱发的神经阻滞剂恶性综合征病例，然后将它们指定为神经阻滞剂恶性综合征的高概率或低概率病例。
19例氯氮平相关的神经阻滞剂恶性综合征病例中有9例，13例利培酮相关的神经阻滞剂恶性综合征病例中有8例被指定为神经阻滞剂恶性综合征的高概率病例。其余病例被指定为低概率病例，因为其表现与治疗无关或未符合该综合征的标准。
服用非典型抗精神病药物的患者可能发生神经阻滞剂恶性综合征，且类似于“经典”神经阻滞剂恶性综合征。然而，副作用特征与神经阻滞剂恶性综合征标准有相当大的重叠，并且非典型抗精神病药物可能导致与神经阻滞剂恶性综合征无关（但被误诊为）的神经毒性。对于新型抗精神病药物导致“非典型”神经阻滞剂恶性综合征，证据不足。
