[Early recognition of antipsychotic malignant syndrome: prevention from worse in young people with dementia].

Antipsychotic malignant syndrome (AMS) sometimes is difficult to recognize. Four young persons with dementia developing AMS are presented. We emphasize that there may be signs to consider this diagnosis and how to distinguish between serotonergic syndrome and delirium. Other patients using antipsychotics may also show subtle signs related to AMS. Risk factors are: organic brain syndrome, delirium and agitation. Safe antipsychotics are non-existing and while the presentation of this syndrome can be diverse, we recommend to determine creatine kinase helping to diagnose AMS in patients showing unexplained complaints of pain, posture abnormalities or swallowing problems. Preventing by using non-drug interventions is of course the best option. Furthermore an experienced care-team can contribute to the timely recognition of AMS. We advise to avoid antipsychotics in patients who have already had a AMS, and if unavoidable, to monitor closely for side effects and creatinine kinase.