Neuroleptic Malignant Syndrome-Symptoms, Causes, Treatment

If neuroleptic malignant syndrome sounds unfamiliar to you, then you should be interested to know what with this type of disease is. Read on.

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Neuroleptic malignant syndrome or NMS is a type of neurological disease that occurs as a reaction to prescription drugs that block the neurotransmitter dopamine. This condition affects nearly 13% of patients taking neuroleptic drugs which are largely used in treating psychosis, with greater incidence of this adverse reaction to the medications among men than women. Studies show that neuroleptic drugs paralyze the autonomic nervous system the duty of which is to regulate involuntary actions like sweating, digestion, blood pressure and heart rate. NMS affects the body temperature, consciousness and muscle tone. However, NMS can be avoided by limiting one’s exposure to neuroleptic drugs.

Who are at Risk of Developing NMS?

Obstruction of dopamine activity is the main cause of NMS. That is why people taking anti-psychotic or neuroleptic drugs as well as those taking anti-Parkinson drugs and high doses of depot medications are at high risk of developing NMS. NMS may also recur to patients with previous bout of the disorder. Other medications that can trigger NMS include Lithium, Amoxapine, Metoclopramide, Promethazine, Prochlorperazine, Risperidone, Clozapine and Anticholinergic drugs.

Signs and Symptoms of Neuroleptic Malignant Syndrome(NMS)

Some of the early notable signs include irritability, fever, muscle cramps, irregular blood pressure and delirium. You shouldn’t take NMS symptoms lightly because it can worsen within days and could lead to seizures, pneumonia, arrhythmias, renal failure, rhabdomyolysis, respiratory failure and cardiac arrest. So you should watch out when the body temperature reaches up to 42.3 degrees Celcius and is accompanied by other symptoms like stiff muscles, catatonia, impaired consciousness, heavy sweating as well as fast respiratory and heart rate.

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Diagnosis and Treatment of Neuroleptic Malignant Syndrome

NMS diagnosis primarily involves tracing the neuroleptic agents responsible for the manifestations of NMS. After which, treatment is made according to the symptoms manifested by the patient. Treatment primarily involves discontinuation of drugs causing the disorder and taking prescribed medicines to restore proper dopamine levels of the body and resolve signs and symptoms. Finally, electroconvulsive therapy might have to be undertaken to resolve severe psychosis.

Prognosis of NMS

There is greater chance for full recovery if NMS is detected and treated early on, though death rate is still noteworthy especially if there is kidney failure and with body temperature exceeding 104 degrees Fahrenheit. For NMS that originated from long-term use of intramuscular preparations, symptoms will remain up to 21 days; while symptoms will last for 10 days for those using oral medications.

NMS Complications

NMS is life-threatening and if it is ignored, it could lead to other health complications such as renal failure, pulmonary embolism, infection, worsening of psychiatric condition and death. Sadly, many are unaware of the health risks that come with taking antipsychotic drugs or medications that contain chemical compounds that suppress the body’s normal level of dopamine.


NMS is treatable with early diagnosis and prompt management. Once you notice combinations of the signs and symptoms cited above, you should not delay medical consultation. Whether you or a loved one has Neuroleptic malignant syndrome, it is very crucial that you take the needed action in order to save you or your loved one’s life.

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