Neuroleptic malignant syndrome: a review

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.
• 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.