Second-Generation Antipsychotics and Neuroleptic Malignant Syndrome: Systematic Review and Case Report Analysis

被引：106
作者：
Belvederi Murri M. [1 ,2 ]
Guaglianone A. [1 ]
Bugliani M. [1 ]
Calcagno P. [1 ]
Respino M. [1 ]
Serafini G. [1 ]
Innamorati M. [3 ]
Pompili M. [3 ]
Amore M. [1 ]
机构：
[1] Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Largo Rosanna Benzi, 10, Genoa
[2] Department of Psychological Medicine, Institute of Psychiatry, King’s College London, London
[3] Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome
来源：
Drugs in R&D | 2015年 / 15卷 / 1期
关键词：
Clozapine; Risperidone; Olanzapine; Quetiapine; Aripiprazole;
D O I：
10.1007/s40268-014-0078-0
中图分类号：
学科分类号：
摘要：
Background: Neuroleptic malignant syndrome (NMS) is a rare, severe, idiosyncratic adverse reaction to antipsychotics. Second-generation antipsychotics (SGAs) were originally assumed to be free from the risk of causing NMS, however several cases of NMS induced by SGAs (SGA-NMS) have been reported.Objectives: The aim of this study was to systematically review available studies and case reports on SGA-NMS and compare the presentation of NMS induced by different SGAs.Data Sources: Citations were retrieved from PubMed up to November 2013, and from reference lists of relevant citations.Study Eligibility Criteria: Eligibility criteria included (a) primary studies reporting data on NMS, with at least 50 % of the sample receiving SGAs; or (b) case reports and case reviews reporting on NMS induced by SGA monotherapy, excluding those due to antipsychotic withdrawal.Study Appraisal and Synthesis Methods: A standardized method for data extraction and coding was developed for the analysis of eligible case reports.Results: Six primary studies and 186 individual cases of NMS induced by SGAs were included. Primary studies suggest that SGA-NMS is characterized by lower incidence, lower clinical severity, and less frequent lethal outcome than NMS induced by first-generation antipsychotics. Systematic analysis of case reports suggests that even the most recently marketed antipsychotics are not free from the risk of inducing NMS. Furthermore, clozapine-, aripiprazole- and amisulpride-induced NMS can present with atypical features more frequently than other SGA-NMS, i.e. displaying less intense extrapyramidal symptoms or high fever.Limitations: Case reports report non-systematic data, therefore analyses may be subject to bias.Conclusions and Implications of Key Findings: Clinicians should be aware that NMS is virtually associated with all antipsychotics, including those most recently marketed. Although apparently less severe than NMS induced by older antipsychotics, SGA-NMS still represent a relevant clinical issue. © 2015, The Author(s).
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页码：45 / 62
页数：17
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