The neuroleptic malignant syndrome is a rare, potentially fatal, adverse reaction to neuroleptic drugs characterised by severe rigidity, high temperature and autonomic dysfunction. In the light of the hypothesized pathophysiology of this condition, a rational approach to the management of patients presenting with temperature and rigidity is provided. The aims of this approach are three-fold: to...

Changes in unscheduled DNA synthesis (UDS) in lymphocytes and lipid peroxidation (LPO) in the rat brain regions cortex, hippocampus and hypothalamus were studied after 12 months of treatment with the neuroleptic fluphenazine (5 mg/kg b.w.), lithium (0.05% in drinking water), alpha-tocopherol (alpha-TP, 0.01% in drinking water) and the anticholinergic drug 7-methoxytacrine (0.1 and 1.0 g/kg in t...

INTRODUCTION A rare side effect of antipsychotic medication is neuroleptic malignant syndrome, mainly characterized by hyperthermia, altered mental state, haemodynamic dysregulation, elevated serum creatine kinase and rigor. There may be multi-organ dysfunction including renal and hepatic failure as well as serious rhabdomyolysis, acute respiratory distress syndrome and disseminated intravascul...

We report a case of severe neuroleptic malignant syndrome with hyperthermia, rhabdomyolysis and hepatic failure where we applied endovascular cooling in order to reverse hyperthermia. After rapid normalization of core temperature at 37.5 degrees C, the patient's condition improved and CK levels dropped. However, upon withdrawl of endovascular temperature control there was a relapse. This is the...

Antipsychotic and antidepressant are often used in combination for the treatment of neuropsychiatric disorders. The concomitant use of antipsychotic and/or antidepressant with drugs that may interact can lead to rare, life-threatening conditions such as serotonin syndrome and neuroleptic malignant syndrome. We describe a patient who has a history of taking two offending drugs that interact with...

Neuroleptic malignant syndrome and serotonin syndrome share many common clinical features, and the term "Neurotoxic syndrome" can be used when a clear distinction cannot be made between the two. Here we present a case of 19-year-old man who experienced serotonin syndrome caused by sertraline intake, and consecutive neuroleptic malignant syndrome by risperidone. This case suggests that these two...

This case report describes a 54-year-old man with bipolar I disorder who was treated with aripiprazole (ARP) and lithium. The patient was admitted to our hospital because of aggravation of depressive symptoms, and treatment with lamotrigine (LTG) was initiated. Two weeks after admission, we discontinued administration of ARP after the appearance of a tremor. Three weeks after discontinuing ARP,...

How "malignant" is the neuroleptic malignant syndrome? In early mild cases it may not be malignant at all Although cases of acute fatal psychoses associated with fever and neuromuscular disturbance have been reported sporadically since the nineteenth century' and the propensity for neuroleptic drugs to disrupt neuromuscular function has been described as their use has grown, the entity of the "...

Neuroleptic malignant syndrome (NMS) is one of the rave but potentially fatal, idiosyncratic reaction to Neuroleptics and other medications (Smego and Durack, 1985). I t is characterised by fever, autonomic dysfunction, rigidity, altered conscious state with associated laboratory parameters like raised GPK, LDH, Hepatic enzymes, leucocytosis. This syndrome was first described by Delay and Denik...

Neuroleptic malignant syndrome (NMS) can be a severe condition requiring emergency treatment. Misdiagnosis or delay in treatment prove fatal. An unusual presentation of NMS is outlined patient being restarted on clozapine following mild COVID‐19 infection. A discussion explores its pathogenicity and the various ways it present clinically, which further illustrates atypical features this case.