Q: All of the following can be used in Neuroleptic Malignant Syndrome (NMS) except

A) Dantrolene,
B) Bromocriptine,
C) Lorazepam
D) Haloperidol 
E) Amantadine


Answer:  D

Objective of above question is to identify the drugs which are commonly get prescribed in ICU and may cause NMS. Commonly known implicated drugs causing NMS are haloperidol, fluphenazine, chlorpromazine, clozapine, risperidone, olanzapine, metoclopramide, promethazine and few others. It is of utmost importance to know that NMS can occur after a single dose of these drugs. As expected, higher doses and parenteral administrations are relatively at higher risk.


References:

1. Seitz DP, Gill SS. Neuroleptic malignant syndrome complicating antipsychotic treatment of delirium or agitation in medical and surgical patients: case reports and a review of the literature. Psychosomatics 2009; 50:8

2. Kogoj A, Velikonja I. Olanzapine induced neuroleptic malignant syndrome--a case review. Hum Psychopharmacol 2003; 18:301