Risk of neuroleptic malignant syndrome in patients with bipolar disorder

A retrospective, population-based case-control study

Yan Chen, Jeff J. Guo, Michael Steinbuch, Peter F Buckley, Nick C. Patel

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Current data regarding risk factors of neuroleptic malignant syndrome (NMS) are limited. This study aims to examine factors associated with increased risk of NMS in patients with bipolar disorder. Methods: A retrospective, population-based, case-control study was performed using a medical claims database covering January 1998 to December 2002. Fifty cases with a diagnosis of NMS were identified and matched with 800 controls. Conditional logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) of risk of NMS. Results: Antipsychotic use was associated with an increased risk of NMS after controlling for other pharmacologic and clinical factors (OR = 2.36, 95% CI = 1.08-5.19). Other factors associated with an increased risk of NMS included being male (OR = 2.07, 95% CI = 1.07-4.02), confusion (OR = 2.91, 95% CI = 1.17-7.28), dehydration (OR = 3.99, 95% CI = 1.50-10.57), delirium (OR = 4.93, 95% CI = 2.07-11.72), and extrapyramidal symptoms (OR = 3.50, 95% CI = 1.10-11.09). Conclusions: Given the widespread use of antipsychotics for the treatment of bipolar disorder, clinicians should be vigilant of the potential pharmacologic and clinical factors associated with increased risk of NMS in patients with bipolar disorder.

Original languageEnglish (US)
Pages (from-to)439-450
Number of pages12
JournalInternational Journal of Psychiatry in Medicine
Volume39
Issue number4
DOIs
StatePublished - Jan 1 2009

Fingerprint

Neuroleptic Malignant Syndrome
Bipolar Disorder
Case-Control Studies
Odds Ratio
Population
Antipsychotic Agents
Confusion
Delirium
Dehydration
Logistic Models
Regression Analysis
Databases

Keywords

  • Antipsychotic
  • Bipolar disorder
  • Casecontrol study
  • Neuroleptic malignant syndrome

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Risk of neuroleptic malignant syndrome in patients with bipolar disorder : A retrospective, population-based case-control study. / Chen, Yan; Guo, Jeff J.; Steinbuch, Michael; Buckley, Peter F; Patel, Nick C.

In: International Journal of Psychiatry in Medicine, Vol. 39, No. 4, 01.01.2009, p. 439-450.

Research output: Contribution to journalArticle

Chen, Yan ; Guo, Jeff J. ; Steinbuch, Michael ; Buckley, Peter F ; Patel, Nick C. / Risk of neuroleptic malignant syndrome in patients with bipolar disorder : A retrospective, population-based case-control study. In: International Journal of Psychiatry in Medicine. 2009 ; Vol. 39, No. 4. pp. 439-450.
@article{dc78ad72867a46f2a49beb1daa87f626,
title = "Risk of neuroleptic malignant syndrome in patients with bipolar disorder: A retrospective, population-based case-control study",
abstract = "Introduction: Current data regarding risk factors of neuroleptic malignant syndrome (NMS) are limited. This study aims to examine factors associated with increased risk of NMS in patients with bipolar disorder. Methods: A retrospective, population-based, case-control study was performed using a medical claims database covering January 1998 to December 2002. Fifty cases with a diagnosis of NMS were identified and matched with 800 controls. Conditional logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) of risk of NMS. Results: Antipsychotic use was associated with an increased risk of NMS after controlling for other pharmacologic and clinical factors (OR = 2.36, 95{\%} CI = 1.08-5.19). Other factors associated with an increased risk of NMS included being male (OR = 2.07, 95{\%} CI = 1.07-4.02), confusion (OR = 2.91, 95{\%} CI = 1.17-7.28), dehydration (OR = 3.99, 95{\%} CI = 1.50-10.57), delirium (OR = 4.93, 95{\%} CI = 2.07-11.72), and extrapyramidal symptoms (OR = 3.50, 95{\%} CI = 1.10-11.09). Conclusions: Given the widespread use of antipsychotics for the treatment of bipolar disorder, clinicians should be vigilant of the potential pharmacologic and clinical factors associated with increased risk of NMS in patients with bipolar disorder.",
keywords = "Antipsychotic, Bipolar disorder, Casecontrol study, Neuroleptic malignant syndrome",
author = "Yan Chen and Guo, {Jeff J.} and Michael Steinbuch and Buckley, {Peter F} and Patel, {Nick C.}",
year = "2009",
month = "1",
day = "1",
doi = "10.2190/PM.39.4.h",
language = "English (US)",
volume = "39",
pages = "439--450",
journal = "International Journal of Psychiatry in Medicine",
issn = "0091-2174",
publisher = "Baywood Publishing Co. Inc.",
number = "4",

}

TY - JOUR

T1 - Risk of neuroleptic malignant syndrome in patients with bipolar disorder

T2 - A retrospective, population-based case-control study

AU - Chen, Yan

AU - Guo, Jeff J.

AU - Steinbuch, Michael

AU - Buckley, Peter F

AU - Patel, Nick C.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Introduction: Current data regarding risk factors of neuroleptic malignant syndrome (NMS) are limited. This study aims to examine factors associated with increased risk of NMS in patients with bipolar disorder. Methods: A retrospective, population-based, case-control study was performed using a medical claims database covering January 1998 to December 2002. Fifty cases with a diagnosis of NMS were identified and matched with 800 controls. Conditional logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) of risk of NMS. Results: Antipsychotic use was associated with an increased risk of NMS after controlling for other pharmacologic and clinical factors (OR = 2.36, 95% CI = 1.08-5.19). Other factors associated with an increased risk of NMS included being male (OR = 2.07, 95% CI = 1.07-4.02), confusion (OR = 2.91, 95% CI = 1.17-7.28), dehydration (OR = 3.99, 95% CI = 1.50-10.57), delirium (OR = 4.93, 95% CI = 2.07-11.72), and extrapyramidal symptoms (OR = 3.50, 95% CI = 1.10-11.09). Conclusions: Given the widespread use of antipsychotics for the treatment of bipolar disorder, clinicians should be vigilant of the potential pharmacologic and clinical factors associated with increased risk of NMS in patients with bipolar disorder.

AB - Introduction: Current data regarding risk factors of neuroleptic malignant syndrome (NMS) are limited. This study aims to examine factors associated with increased risk of NMS in patients with bipolar disorder. Methods: A retrospective, population-based, case-control study was performed using a medical claims database covering January 1998 to December 2002. Fifty cases with a diagnosis of NMS were identified and matched with 800 controls. Conditional logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) of risk of NMS. Results: Antipsychotic use was associated with an increased risk of NMS after controlling for other pharmacologic and clinical factors (OR = 2.36, 95% CI = 1.08-5.19). Other factors associated with an increased risk of NMS included being male (OR = 2.07, 95% CI = 1.07-4.02), confusion (OR = 2.91, 95% CI = 1.17-7.28), dehydration (OR = 3.99, 95% CI = 1.50-10.57), delirium (OR = 4.93, 95% CI = 2.07-11.72), and extrapyramidal symptoms (OR = 3.50, 95% CI = 1.10-11.09). Conclusions: Given the widespread use of antipsychotics for the treatment of bipolar disorder, clinicians should be vigilant of the potential pharmacologic and clinical factors associated with increased risk of NMS in patients with bipolar disorder.

KW - Antipsychotic

KW - Bipolar disorder

KW - Casecontrol study

KW - Neuroleptic malignant syndrome

UR - http://www.scopus.com/inward/record.url?scp=76949103436&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76949103436&partnerID=8YFLogxK

U2 - 10.2190/PM.39.4.h

DO - 10.2190/PM.39.4.h

M3 - Article

VL - 39

SP - 439

EP - 450

JO - International Journal of Psychiatry in Medicine

JF - International Journal of Psychiatry in Medicine

SN - 0091-2174

IS - 4

ER -