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re: atypical NMS » maxx44

Posted by Larry Hoover on January 3, 2004, at 20:35:28

In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 19:36:51

why did you quote the lowest figure possible?

I didn't. I quoted one midspectrum, with a large N size. I tend to ignore outlier stats, or those based on small samples. I am a professional scientist, and I am using my scientific judgment. I originally quoted a median value.

I supplied a reference with a larger N, and a lower incidence, of 0.02%. (19 cases out of 78,708), but that is lower than the more typical figure.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10954877&dopt=Abstract

Each reference with higher incidence had much much smaller N, some as few as 7 subjects.

Lar

Here's another with large sample, small incidence.

Can J Clin Pharmacol. 2003 Fall;10(3):111-3.

Neuroleptic malignant syndrome in Mexico.

Montoya A, Ocampo M, Torres-Ruiz A.

Brain Imaging Group, Douglas Hospital Research Centre, McGill University, 6875 Boulevard LaSalle, Verdun, Quebec H4H 1R3, Canada. alonzo.montoya@douglas.mcgill.ca

BACKGROUND: Neuroleptic Malignant Syndrome (NMS) is an uncommon but potentially fatal complication of antipsychotic and neuroleptic drug treatment. OBJECTIVES: This study estimated the frequency, clinical presentation, and outcome of NMS in a referral center for neurological, neurosurgical and psychiatric disorders in Mexico. METHODS: The authors conducted a thorough search of psychiatry, neurology, neurosurgery and intensive care unit records for cases of NMS during the 10-year period between 1990 and 1999. They examined the clinical features, course and treatment of the NMS episodes, and performed a follow-up survey for residual symptoms and clinical outcome. The mean time to follow-up assessment was 36 months. RESULTS: A total of eight of 4831 neuroleptic-treated patients had an episode of NMS (incidence 0.165%). Seven of the eight patients were treated with haloperidol. Other neuroleptics agents associated with NMS were depot pipotiazine palmitate and levomepromazine maleate. One patient received lithium concomitantly. No fatal outcome was found. Only one patient developed persistent clinical sequelae, consisting of extrapyramidal and cerebellar symptoms, three years after the NMS episode. CONCLUSIONS: The slightly low frequency of NMS found in this study compared with studies conducted in other countries may be attributable to the advent and use of newer atypical antipsychotics in Mexico, the rigorous demands for NMS diagnostic criteria and the lack of familiarity with the diagnosis between physicians.

 

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poster:Larry Hoover thread:13781
URL: http://www.dr-bob.org/babble/20031231/msgs/296141.html