Neuroleptic malignant syndrome: a clinical conundrum

The neuroleptic malignant syndrome (NMS) is a potentially fatal complication of antipsychotic pharmacotherapy. The incidence rate of NMS is about 2% of all patients receiving neuroleptics, while the overall mortality rate is in excess of 10%. Inconsistences in the diagnostic criteria for NMS have resulted in a variety of presentations and precipitating factors being associated with this condition, which in turn has led to the reporting of contradictory research findings. This article summarizes the literature with respect to the diagnosis and treatment of neuroleptic malignant syndrome and the challenge of subsequent management of the psychotic patient.