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Neuroleptic malignant syndrome (NMS) is a rare [5] [6] but life-threatening reaction that can occur in response to antipsychotics (neuroleptic) or other drugs that block the effects of dopamine. [ 1 ] [ 7 ] Symptoms include high fever , confusion, rigid muscles, variable blood pressure, sweating, and fast heart rate. [ 1 ]
These side effects are serious and some of them are permanent, and many remain a crucial concern for companies and healthcare professionals and substantial efforts are being encouraged to reduce the potential risks for future antipsychotics through more clinical trials and drug development.
The reaction is not life-threatening. [2] For clarification, oculogyric seizures, also termed versive seizures, represent one of the manifestations of epilepsy. These seizures exhibit the same upward eye movement observed in OGC but are classified as a specific subtype of epilepsy. [3]
As haloperidol is a high-potency typical antipsychotic, it tends to produce significant extrapyramidal side effects. According to a 2013 meta-analysis of the comparative efficacy and tolerability of 15 antipsychotic drugs it was the most prone of the 15 for causing extrapyramidal side effects.
Haloperidol decanoate is provided in the form of 50 or 100 mg/mL oil solution of sesame oil and benzyl alcohol in ampoules or pre-filled syringes. [6] [7] [9] Its elimination half-life after multiple doses is 21 days. [10] [11] The medication is marketed in many countries throughout the world. [3] [12
Serious side effects may include low blood pressure or heart attack. [10] Whether use is safe during pregnancy or breastfeeding is unclear. [2] [10] When used by people with liver problems, and in elderly individuals, doses should be reduced. [10] Amlodipine works partly by vasodilation (relaxing the arteries and increasing their diameter). [10]
It is the strongest warning that the FDA requires, and signifies that medical studies indicate that the drug carries a significant risk of preventable, serious or even life-threatening adverse effects. [2] [3] Economists and physicians have thoroughly studied the effects of FDA boxed warnings on prescription patterns.
One report found that haloperidol could be used during pregnancy, [135] to minimize the side effects in the mother, including low blood pressure, and anticholinergic effects, [136] although it may cross the placenta. [133] If severe tics might interfere with administration of local anesthesia, other anesthesia options are considered. [133]