Risk Factors in Neuroleptic Malignant Syndrome: A 10-year Case-control Study of Neuroleptic Use in Patients in Charoenkrung Pracharak Hospital
DOI:
https://doi.org/10.33192/smj.v77i7.273739Keywords:
Neuroleptic malignant syndrome, maximum dose of neuroleptic per day, neuroleptic dose increase final 5 days, delirium, dehydration, electrolyte imbalanceAbstract
Objective: To identify the risk of using high doses of neuroleptics in the development of neuroleptic malignant syndrome (NMS). Additionally, we examined other potential risk factors, including age, psychiatric diagnosis, route of neuroleptic administration, dose escalation over a short period, psychomotor agitation, dehydration, and electrolyte imbalance.
Materials and Methods: A case-control study was performed, comprising 26 NMS cases matched with 52 controls by sex and time of admission to the hospital over a 10-year data-collection period. A retrospective chart review was conducted to compare the two groups using conditional logistic regression analysis.
Results: The maximum neuroleptic dose (adjusted OR 10.70, 95%CI 1.79–64.00 for a neuroleptic dose of 200–400 mg/day and adjusted OR 61.58, 95%CI 6.87–552.19 for a neuroleptic dose > 400 mg/day) and dehydration (adjusted OR 18.52, 95%CI 3.22–106.62) were found to be significant risk factors for developing NMS.
Conclusion: The risk factors for developing NMS were found to be receiving a high dose of neuroleptics per day and dehydration.
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