Neuroleptic malignant syndrome: a guide for psychiatrists

Journal article

Wadoo, O., Ouanes, S. and Firdosi, M. 2021. Neuroleptic malignant syndrome: a guide for psychiatrists. BJPsych Advances. 27 (6), pp. 373-382.
AuthorsWadoo, O., Ouanes, S. and Firdosi, M.

Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal adverse reaction to drugs. In psychiatric practice, it is mainly associated with antipsychotics. The classic presentation is that of hyperpyrexia, muscle rigidity, mental state changes and autonomic instability. Subtle forms are difficult to recognise owing to symptom overlap with other conditions. This article discusses the clinical presentation of the syndrome, its differential diagnosis and use of supportive care, medication and electroconvulsive therapy in its treatment. It also explores prevention of NMS and reinstatement of treatment after an episode. It is stressed that all but the mildest forms of NMS should be considered a medical emergency that is properly managed in an acute hospital.

KeywordsAntipsychotics; Drug interactions and side-effects; Neuroleptic malignant syndrome; Schizophrenia
JournalBJPsych Advances
Journal citation27 (6), pp. 373-382
PublisherCambridge University Press
Digital Object Identifier (DOI)
Official URL
Publication dates
Online23 Oct 2020
Publication process dates
Accepted04 Sep 2020
Deposited08 Jun 2023
Output statusPublished
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