항정신병약물성 악성증후군

Neuroleptic Malignant Syndrome

The recent increase in the reporting of NMS in the psychiatric and medical literature is most likely due to our increasing awareness of the syndrome. The nuroleptic malignant syndrome is an acute disorder of thermoregulation and neuromotor control, and it appears that decreased dopaminergic tone in the striatum and in the hypothalamus may underlie the development of EPS and altered thermorgulation in NMS. Identifying biological markers and exploring potential pathophysiological mechanisms will be important Such reasarch could be leaded by clues regarding the pathogenesis of similar disorder, such as malignant hyperthermia, lethal catatonia. This type of research would be significantly enhanced by the development of appropriate animal models. There is a ongoing debate about whether NMS is a spectrum diorger and there have been numerous observations of atypical cases that may lack one of the key features or present with only mild to moderate evidence of one or more features. There is a great need to for a more sophisticated epidemiological approach on the basis of case reports. The subject of NMS has continued to cause considerable interest particularly in Korea where there is still no study articles about its incidence or treatment Recently it is reported that at the relatively low dose of neuroleptis, a large percentage of patients showed adequate response, theoretically minimize the risk of NMS. It is needed to be more attentive to a growing body of literature indicating that “less may indeed be more” when it comes to the dose of neuroleptic. Case reports and controlled prospective studies will be necessary to accomplish this. Clearly, there is much we do not understand about this potentially fatal diorder. Future research could importantly serve our efforts in prevention and therapy and greatly enhance our understanding of basic pathophsiological mechanisms