Judicious use of antipsychotic medications includes:[1]Strawn JR, Keck PE Jr, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry. 2007 Jun;164(6):870-6.
http://www.ncbi.nlm.nih.gov/pubmed/17541044?tool=bestpractice.com
[37]Mall GD, Hake L, Benjamin AB, et al. Catatonia and mild neuroleptic malignant syndrome after initiation of long-acting injectable risperidone: case report. J Clin Psychopharmacol. 2008 Oct;28(5):572-3.
http://www.ncbi.nlm.nih.gov/pubmed/18794658?tool=bestpractice.com
[38]Reulbach U, Dütsch C, Biermann T, et al. Managing an effective treatment for neuroleptic malignant syndrome. Crit Care. 2007;11:R4.
http://ccforum.biomedcentral.com/articles/10.1186/cc5148
http://www.ncbi.nlm.nih.gov/pubmed/17222339?tool=bestpractice.com
Using the lowest effective dose of antipsychotic medication
Avoiding rapid escalation of antipsychotic medication dosing if possible
Avoiding concurrent use of multiple medications if possible
Avoiding abrupt withdrawal of dopaminergic drugs, especially in compromised patients (e.g., Parkinson disease)
Treating agitation early, using alternatives to antipsychotic medication (e.g., lorazepam) when possible
Avoiding dehydration.
The use and dose of antipsychotic medication should be minimized and agitation treated.