Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS) is a rare but life-threatening reaction, usually to antipsychotic medications, characterized by fever, rigidity, altered mental status, and autonomic instability.

Table of Contents

Quick Facts

  • ICD-10: G21.0
  • Severity: Life-threatening

Call 911

High fever with rigidity, confusion, sweating, and abnormal vital signs in someone on antipsychotic (or rarely metoclopramide) — go to the emergency department immediately.

Features

  • High fever
  • Severe muscle rigidity ('lead pipe')
  • Altered mental status
  • Autonomic instability (BP fluctuations, fast heart rate, sweating)
  • Elevated CK in blood

Treatment

  • Stop the offending medication immediately
  • Aggressive supportive care (cooling, fluids, monitoring)
  • Dantrolene, bromocriptine, or amantadine in severe cases
  • ICU care

Related Conditions

Serotonin Syndrome

Different medication emergency
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Psychiatric Association. NMS Information.