All of the following drugs can cause neurolepticmalignant syndrome except aEUR'
Domperidone Neurolept malignant syndrome is a potentially life threatening idiosyncratic reaction to neuroleptic drugs. It causes :? Fever Muscular rigidity Altered mental status Autonomic dysfunction The underlying pathological abnormality is thought to be central D2 receptor blockade or dopamine depletion in the hypothalamus and nigrostriatal / spinal pathways. This leads to an elevated temperature set point, impairment of normal thermal homeostasis and extrapyramidally induced muscle regidity. Thus it is usually associated with potent neuroleptics such as haloperidol and fluphenazine, which block central D2 receptors but it has now been repoed to occur with all drugs that affect the central dopaminergic system (including dopamine agonists and levodopa). In these cases neurolept malignant syndrome is precipitated by rapid withdrawl of the dopaminergic agonists. Amantadine Amantadine is a dopamine agonist and its withdrawl precipitates neurolept malignant syndrome. N.M.S. is also associated with other drugs that have central D2 receptor antagonist activity e.g. Metoclopromide. Metoclopromide is a D2 blocker. Can cross the C.N.S. and cause neurolept malignant syndrome. Domperidone Like metoclopromide is a D2 blocker and is similar to metoclopromide in all respects, except that, Domeperidone does not cross C.N.S. and so it does not generally cause neurolept malignant syndrome. But rare cases of N.M.S. of have been repoed with Domeperidone, too. So all the drugs mentioned in the question can cause neurolept malignant syndrome. Some believe that answer should be Amantadine as it causes N.M.S due to drug withdrawl, we are not convinced. But, we are not sure of the answer.
Amantadine
Domperidone
Haloperidol
Metoclopramide