[Extrapyramidal reactions and neuroleptic malignant syndrome]

The extrapyramidal side effects of neuroleptics vary not only in their clinical manifestations, but also in the severity of the symptoms and the response to treatment. The most common reactions are Parkinson-like symptoms, dystonias, dyskinesias and akathisia. All of these are reversible side effects and in general respond well to the administration of anti-parkinson medication. On the other hand, tardive dyskinesia is an involuntary movement disorder that is irreversible and difficult to treat. Some forms of severe Parkinsonism may evolve at times into akinetic and catatonic forms and, even worse, into a morbid and lethal condition called the neuroleptic malignant syndrome. The case presented here responded well to the use of amantadine hydrocloride, but not all cases respond well. Psychiatric research regarding the use of dantrium would be most important and beneficial. This treatment is known more to anesthesiologists as effective in the treatment of a syndrome characterized by profound rigidity accompanied by neurovegetative symptoms and high fever found as a complication of general anesthesia. However, in the United States there are legal obstacles to test this drug with psychiatric patients. It is possible that these restrictions are less rigid in Latin America.