Fact 8: Possible Recurrence
While a successfully treated episode of Neuroleptic Malignant Syndrome (NMS) can lead to full recovery, there is an undeniable risk of recurrence. Studies have indicated that anywhere from 30% to over 60% of patients who experienced an initial episode of NMS may be at risk for a recurrence. This presents an important consideration in the ongoing care and management of patients who have had NMS.
Certain factors may increase the risk of NMS recurrence. For example, re-exposure to antipsychotic medication—particularly the same drug involved in the initial NMS episode—can potentially trigger a recurrence. Other factors such as the rapid initiation of drug therapy, the use of high potency antipsychotic drugs, and the presence of underlying neurological disorders can also contribute to the recurrence risk.
If reintroduction of antipsychotic medication is necessary, it should be done with extreme caution. A different antipsychotic drug should ideally be chosen, and it should be introduced at a low dose with gradual titration under close monitoring. It’s crucial to note that the decision to reintroduce antipsychotic drugs should be made only when absolutely necessary and after a thorough risk-benefit analysis.
Patient education plays a vital role in preventing NMS recurrence. Patients who have experienced an NMS episode should be thoroughly educated about the condition, its symptoms, and the risk factors for recurrence. They should also be informed about the need to seek immediate medical help should symptoms re-emerge. This knowledge is key to the early detection and intervention of potential NMS recurrence.
Regular follow-up and close monitoring are crucial in managing the risk of NMS recurrence. Health professionals should keep a watchful eye for any sign of symptom recurrence during the follow-up visits. Given the potentially life-threatening nature of NMS, the management of recurrence risk forms a central part of the long-term care plan for NMS patients. (8)
