In Reply: Neuroleptic Malignant Syndrome

Abstract

We appreciate the letter of Dr Edwards, which draws attention to the potential risk of antiemetics for causing neuroleptic malignant syndrome (NMS). As we indicated in our article, the mechanism of action shared by drugs that cause NMS is blockade of brain dopamine receptors. Antiemetics, commonly used in pediatrics, such as prochlorperazine maleate and metoclopramide, act by blocking central dopamine receptors and have a propensity for precipitating acute extrapyramidal symptoms, ie, dystonic reaction. Dehydration is a frequent complication of recurrent vomiting in children, that is an indication for prescribing antiemetics.