Fluoxetine and neuroleptic malignant syndrome

The authors present a case report of neuroleptic malignant syndrome (NMS) in a patient commencing treatment with fluoxetine alone who had previously been treated with several antipsychotic and antidepressant combinations. On reviewing the literature on the pathogenesis of NMS, the authors hypothesize a facilitative role of the neurotransmitter serotonin (5-HT) in conjunction with central dopaminergic blockade in the precipitation of NMS.