Malignant neurolept hyperthermia (NMS) seen in all except:
a. Rest of them are D2 blockers (BG Katzung, Basic and Clinical Pharmacology; 10th Edition’ 2007, pp-54-55). Amantadine is a dopamine transmission facilitator and is used in treatment of Parkinson’s disease. Indeed, it is the most effective drug for treatment of motor fluctuations. It also has antiviral properties.
b. It blocks the release of virons.
c. NMS is a life threatening condition most often caused by D2 blockers. It is treated by oxygen, external cooling and IV dantrolene.
d. Bromocriptine can also be used. Studies indicate that there are genetically reduced D2 receptors present in these patients.
e. Therefore, it is also a pharmacogenetic condition. Muscle rigidity is the first symptom to develop followed by fever and autonomic instability.