Clozapine-induced neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS), a rare but serious side effect of psychotropic drugs, is usually attributed to blockade of striatal and hypothalamic dopaminergic tracts. Clozapine is an atypical antipsychotic that has minimal extrapyramidal effects and might not be expected to cause NMS. The authors report the development of NMS in a 30-year-old white man after three 25-mg clozapine doses. To their knowledge, this is the first case of NMS linked with clozapine in which concurrent psychotropic medications cannot be implicated.