Algorithms for the treatment of acute side effects induced by neuroleptics

This article focuses especially on acute extrapyramidal symptoms (EPS) and neuroleptic malignant syndrome (NMS) induced by antipsychotic treatments. S trategies for the management of acute EPS may include changing the neurolep tic (NL) to an alternative one, i.e. switching to a low-potency or an atypi cal antipsychotic, lowering the dosage or discontinuing the NL, and adding a drug effective in treating EPS. The important factors in the management o f NMS are early recognition, immediate discontinuation of antipsychotic med ications and prompt institution of supportive care. Dantrolene and/or bromo criptine are found to be the most effective for the second-step treatment o f NMS in Japan.