A Serious Side Effect of Antipsychotic Therapy: Neuroleptic Malign Syndrome

Neuroleptic malign syndrome (NMS) is a rare, idiosyncratic, potentially life-threatening complication of treatment with dopamine receptor antagonists. NMS is characterized by fever, severe muscle rigidity and autonomic and mental status changes. Here, we present three NMS cases admitted to our emergency service between January 2010 and April 2011. NMS has the characteristics of acute onset, hyperthermia, profound mental changes, heightened motor activity and autonomic symptoms. Aggressive and timely intervention is crucial due to the potential for fatal outcomes. Immediate withdrawal of the offending agent followed by supportive care is the treatment of choice for most patients. Supportive care includes the infusion of intravenous fluids for hydration and treatment with benzodiazepines to manage irritation.