Various drugs, including antipsychotics like risperidone (ROR 45.11) and non-antipsychotics, were significantly associated with neuroleptic malignant syndrome, and several drug combinations synergistically increased this risk.
Observational (n=2,991)
Do specific drugs and drug combinations increase the risk of developing neuroleptic malignant syndrome?
Pharmacovigilance analysis confirms that various drugs, including non-antipsychotics, and specific drug combinations like risperidone and lithium, are significantly associated with an increased risk of neuroleptic malignant syndrome.
Odds Ratio: 45.11 (95% CI 39.4–51.65)
Neuroleptic malignant syndrome (NMS) is a rare but serious and sometimes fatal complication in patients taking antipsychotic drugs, and its underlying mechanism still remains unclear. The pharmacotherapy for psychotic disorders is complicated and often involves a combination of two or more drugs, including drugs other than antipsychotics. In the present study, we used the Japanese Adverse Drug Event Report (JADER) database to broadly investigate the drugs associated with NMS, following their related pathways, as well as the drug-drug interactions (DDIs) in NMS. All analyses were performed using data from the JADER database from April 2004 to May 2022. Single-drug signals were evaluated using the reporting odds ratio (ROR) and proportional reporting ratio (PRR), and drug pathways were investigated using the Kyoto Encyclopedia of Genes and Genomes (KEGG). DDIs were evaluated using the Ω shrinkage measure and Chi-square statistics models. All drugs associated with 20 or more NMS cases in the JADER database exhibited signals for NMS, including non-antipsychotics. Pathways associated with the drugs included the dopaminergic or serotonergic synapses related to antipsychotics. DDIs leading to NMS were confirmed for several drug combinations exhibiting single-drug signals. This study confirmed the significant association of various drugs, including non-psychotics, with NMS and suggested that various pathways related to these drugs may be involved in the progression of NMS. In addition, several combinations of these drugs were found to interact (DDI), increasing the risk of NMS, which suggests that appropriate caution should be taken when administering these drugs.
Kyotani et al. (Fri,) conducted a observational in Neuroleptic malignant syndrome (n=2,991). Antipsychotics and non-antipsychotic drugs (e.g., Risperidone) vs. Other drugs in the database was evaluated on Neuroleptic malignant syndrome reporting odds ratio (Risperidone) (ROR 45.11, 95% CI 39.40-51.65). Various drugs, including antipsychotics like risperidone (ROR 45.11) and non-antipsychotics, were significantly associated with neuroleptic malignant syndrome, and several drug combinations synergistically increased this risk.