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Neuroleptic malignant syndrome: a review

A L Pelonero1, J L Levenson, A K Pandurangi

  • 1Department of Psychiatry at Virginia Commonwealth University-Medical College of Virginia, Richmond 23298-0710, USA. apelonero@hsc.vcu.edu

Psychiatric Services (Washington, D.C.)
|September 15, 1998
PubMed
Summary

Neuroleptic malignant syndrome (NMS) is a rare but serious side effect of antipsychotics. Early recognition and supportive care are crucial for patient recovery, which typically occurs within two weeks.

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Area of Science:

  • Neurology
  • Pharmacology
  • Internal Medicine

Background:

  • Neuroleptic malignant syndrome (NMS) is an uncommon adverse reaction to antipsychotic medications.
  • Characterized by hyperthermia, severe muscle rigidity, autonomic instability, and altered mental status.

Purpose of the Study:

  • To provide a concise review of NMS for clinical practitioners.
  • To offer practical information for recognizing and managing NMS in real-world settings.

Main Methods:

  • A literature search of MEDLINE from 1966 to 1997 was conducted.
  • Included key reviews, case series, individual case reports, and other relevant literature.

Main Results:

  • All neuroleptics, including atypical antipsychotics, can induce NMS.

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  • Diagnostic criteria and differential diagnosis considerations have evolved.
  • Key diagnostic tests include creatinine phosphokinase, white blood cell count, and other laboratory and imaging studies.

    • Conclusions:

    • NMS should be considered in patients on neuroleptics with fever or rigidity.
    • Supportive care, including antipyretics and hydration, is critical.
    • Most patients recover within 2-14 days with supportive management.