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Neuroleptic malignant syndrome precipitated by chlorpromazine: a case report

Abdirahman Abdikadir Osman1, Hussein Mahdi Ahmed1, Mustafa Abdulrahman Ali2

  • 1Internal Medicine Department, Royal Hospital, Mogadishu, Somalia.

Journal of Medical Case Reports
|July 15, 2026
PubMed
Abstract

Insights

Neuroleptic malignant syndrome (NMS) can occur rapidly after a single dose of chlorpromazine. Early recognition and treatment of NMS are crucial for patient recovery.

Area of Science:

  • Neuroscience
  • Pharmacology

Background:

  • Neuroleptic malignant syndrome (NMS) is a rare, life-threatening reaction to dopamine-blocking agents.
  • While often linked to high-dose or prolonged antipsychotic use, NMS can manifest even after a single therapeutic dose.

Purpose of the Study:

  • To report a case of acute NMS following a single intramuscular dose of chlorpromazine.
  • To emphasize the potential for rapid onset and the importance of early diagnosis and management of NMS.

Main Methods:

  • A case presentation of a 56-year-old Somali man who developed NMS shortly after receiving chlorpromazine for agitation.
  • Diagnostic evaluation included exclusion of alternative conditions and assessment of clinical and biochemical markers.
  • Treatment involved chlorpromazine discontinuation, supportive care, and bromocriptine administration.

Main Results:

  • The patient presented with classic NMS symptoms: hyperthermia, severe rigidity, altered mental status, autonomic instability, and elevated creatine kinase.
  • Prompt intervention led to rapid clinical and biochemical improvement.
  • This represents the first reported instance of chlorpromazine-induced NMS in a patient from Somalia.

Conclusions:

  • Neuroleptic malignant syndrome can emerge quickly, even with a single, low-dose therapeutic administration of chlorpromazine.
  • Timely recognition and management are critical for achieving positive patient outcomes.
  • This case underscores the need for vigilance regarding NMS in diverse populations.
Keywords:
Antipsychotic adverse effectsCase reportChlorpromazineDopamine blockadeNeuroleptic malignant syndromeRhabdomyolysisSomalia

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