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The Myth of Elevated Serum Creatine Phosphokinase Level and Neuroleptic Malignant Syndrome

Published online by Cambridge University Press:  02 January 2018

Adityanjee
Adityanjee*
Affiliation:
Department of Psychiatry, The Maudsley Hospital, Denmark Hill, London SE5 8AZ
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Extract

The 1980s witnessed the honeymoon between American psychiatry and an enigmatic and mysterious drug complication called neuroleptic malignant syndrome (NMS). I fear that the 1990s are witnessing the same in British psychiatry. Gone is the era when case reports in British literature described the syndrome without identifying it by name (Allan & White, 1972; Moyes, 1973), ostensibly owing to lack of awareness. Probably, no one had bothered to read the original description in the French-language literature (Delay et al, 1960). The pendulum has now swung to the other extreme. Every known drug-related complication is being labelled NMS. In the US, Addonizio et al (1986) suggested a ridiculously high incidence figure of 12.2%. The same trend for overdiagnosis is seen in the recent case report by Dalkin & Lee (1990). The authors of this case report seem to have forgotten that NMS is an idiosyncratic adverse drug reaction which is dose-independent. There is no reason to label every neuroleptic overdose as NMS on grounds of raised creatine phosphokinase (CPK) level.

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Information
The British Journal of Psychiatry , Volume 158 , Issue 5 , May 1991 , pp. 706 - 707
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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