Atypical Antipsychotics Use and Neuroleptic Malignant Syndrome: A Review With a Clinical Perspective

Abstract

Neuroleptic malignant syndrome (NMS) is a potentially life-threatening idiosyncratic reaction associated with the use of antipsychotic medications, characterized by hyperthermia, muscle rigidity, and alterations in consciousness. Despite a reduction in its incidence due to the predominance of atypical antipsychotics in contemporary treatment regimens, NMS remains a critical neuropsychiatric emergency that warrants vigilant attention. There is a hypothesis proposing that catatonia and NMS may exist along a continuum of the same disorder, and evidence suggests that lorazepam may offer therapeutic benefits for both conditions. It is potential for the concurrent occurrence of NMS and serotonin syndrome when antipsychotics and antidepressants are administered concomitantly. This paper presents a case of NMS following the reinitiation of antipsychotic treatment over an extended duration, a scenario inadequately addressed in existing reports, and discusses strategies for its management in clinical practice.