Neuroleptic malignant syndrome

Last updated: July 5, 2021

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Neuroleptic malignant syndrome (NMS) is a life-threatening neurological disorder usually associated with antipsychotics. Clinical features include fever, muscle rigidity, autonomic instability, and mental status changes. Laboratory measures often show an elevated creatine kinase and myoglobinuria as a sign of rhabdomyolysis. Management includes discontinuation of the antipsychotic drug, supportive measures, and administration of dantrolene.

FALTER: Fever, Autonomic instability, Leukocytosis, Tremor, Elevated enzymes (creatine kinase, transaminases), and Rigor are the different symptoms of neuroleptic malignant syndrome.


The differential diagnoses listed here are not exhaustive.


  1. Sahoo MK, Agarwal S, Biswas H. Catatonia versus neuroleptic malignant syndrome: the diagnostic dilemma and treatment. Ind Psychiatry J. 2014; 23 (2): p.163-165. doi: 10.4103/0972-6748.151703 . | Open in Read by QxMD
  2. Lang F, Lang S, Becker T, Jäger M. Neuroleptic malignant syndrome or catatonia? Trying to solve the catatonic dilemma. Psychopharmacology. 2015; 232 (1): p.1.
  3. Perry PJ, Wilborn CA. Serotonin syndrome vs neuroleptic malignant syndrome: a contrast of causes, diagnoses, and management.. Ann Clin Psychiatry. 2012; 24 (2): p.155-162.

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