Neuroleptic malignant syndrome in patients with cancer: a systematic review.
Journal
BMJ supportive & palliative care
ISSN: 2045-4368
Titre abrégé: BMJ Support Palliat Care
Pays: England
ID NLM: 101565123
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
11
01
2020
revised:
07
04
2020
accepted:
20
04
2020
pubmed:
18
5
2020
medline:
15
12
2020
entrez:
17
5
2020
Statut:
ppublish
Résumé
Antipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist. We aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer. We conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS. Eleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32-83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary. Although NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.
Sections du résumé
BACKGROUND
BACKGROUND
Antipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist.
AIMS
OBJECTIVE
We aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer.
METHODS
METHODS
We conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS.
RESULTS
RESULTS
Eleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32-83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary.
CONCLUSION
CONCLUSIONS
Although NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.
Identifiants
pubmed: 32414787
pii: bmjspcare-2020-002200
doi: 10.1136/bmjspcare-2020-002200
doi:
Substances chimiques
Antipsychotic Agents
0
Dopamine D2 Receptor Antagonists
0
Dantrolene
F64QU97QCR
Haloperidol
J6292F8L3D
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
265-270Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: CK reports other from Sumitomo Dainippon Pharma, other from Stella Pharma Corporation, other from CMIC, other from Suntory Beverage & Food, other from Kaken Pharmaceutical, other from Astellas Pharma, other from Mitsubishi Tanabe Pharma Co, other from AbbVie, other from Santen Pharmaceutical, other from Daiichi Sankyo, other from Takeda Pharmaceutical, other from Boehringer Ingelheim Japan, other from School Health Record Centre, other from Real World Data, outside the submitted work.