Risk of neuroleptic malignant syndrome with recent antipsychotic use
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Risk of neuroleptic malignant syndrome with recent antipsychotic use Recent exposure to any antipsychotic is associated with an increased risk of neuroleptic malignant syndrome (NMS), according to a study from Hong Kong. The population-based cohort study assessed the incidence risk of NMS for large a cohort of patients with any antipsychotic prescription who had a first diagnosis of NMS between January 2004 and December 2016 using data from the Hong Kong Hospital Authority clinical database. Furthermore, the risk of NMS with recent exposure to antipsychotics was assessed using a case-crossover analysis. In the population-based cohort study, which included data from 297 647 patients prescribed antipsychotics, the incidence risk of NMS was 0.11%. Twenty patients died within 30 days of the index date, resulting in a 30-day all-cause mortality of 6.0%. Most patients died from sepsis or pneumonia. Only one case had NMS recorded as the primary cause of death. The case-crossover analysis, which included data from 336 patients, showed an increased probability of exposure to any antipsychotic during the 30 days prior to the diagnosis of NMS, compared with an earlier reference period 91–120 days before the index date. In particular, the results showed an increased risk of NMS associated with exposure to haloperidol (odds ratio [OR] 4.40, 95% CI 1.97, 9.81) and quetiapine (OR 4.32; 95% CI 1.70, 10.97), but not to risperidone (OR 2.00; 95% CI 0.93, 4.32) or olanzapine (OR 1.23; 95% CI 0.47, 3.18). Lao KSJ, et al. Antipsychotics and Risk of Neuroleptic Malignant Syndrome: A Population-Based Cohort and Case-Crossover Study. CNS Drugs : 3 Oct 2020. Available 803508619 from: URL: https://doi.org/10.1007/s40263-020-00767-9
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Reactions 17 Oct 2020 No. 1826
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