NEUROLEPTIC MALIGNANT SYNDROME

Abstract

This literature review gathered articles published preferably in English, Spanish, French and Portuguese in the last five years in the PUBMED database, aiming to review the clinical presentation, diagnosis and treatment of neuroleptic malignant syndrome. Neuroleptic Malignant Syndrome (NMS) is a rare and serious complication associated with the use of antipsychotics, characterized by hyperthermia, muscle rigidity, altered mental status and autonomic dysfunction. Neuroleptic medications, especially typical ones, are the main culprits, but atypical antipsychotics and other antidopaminergic agents can also trigger the condition. The mechanism involves the blockade of dopamine receptors, leading to motor and autonomic dysfunction. The diagnosis is clinical, supported by laboratory tests, such as increased creatine kinase. Treatment includes immediate discontinuation of the neuroleptic, intensive support, cooling and medications such as dantrolene and bromocriptine. Complications such as rhabdomyolysis and renal failure can occur, and the prognosis depends on the rapidity of management. Prevention involves cautious use of antipsychotics, especially in at-risk patients, and education about the signs of the syndrome. With early diagnosis, recovery is usually complete, but the syndrome can be fatal without proper treatment.