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Critical Care Toxicology pp 661–677Cite as

Neuroleptic Malignant Syndrome

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Abstract

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic complication of antipsychotic drug therapy. It was first described in 1960 when Delay and colleagues [1] reported rigidity and fever associated with haloperidol therapy. The syndrome subsequently was named and classified as a drug-induced extrapyramidal syndrome (EPS) by Delay and Deniker in 1968 [2]. The term neuroleptic malignant syndrome is derived from the French syndrome malin des neuroleptiques [3]. Although now infrequently fatal and not always associated with antipsychotic therapy, NMS remains the preferred term to describe this illness.

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Authors and Affiliations

  1. Program in Medical Toxicology, Division of Emergency Medicine, Children’s Hospital Boston, Boston, MA, USA

    Rebecca E. Bruccoleri

  2. Division of Toxicology, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Michael J. Burns

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Correspondence to Rebecca E. Bruccoleri .

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Editors and Affiliations

  1. Department of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado, School of Medicine, Aurora, Colorado, USA

    Jeffrey Brent

  2. FDA, Office of New Drugs/Immediate Office, Center for Drug Evaluation and Research, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas’ Hospital, Silver Spring, Maryland, USA

    Paul Dargan

  4. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Benjamin Hatten

  5. Medical Toxicological Intensive Care Unit, Lariboisiere Hospital, Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Robert Palmer

  7. Toxinology Department, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia

    Julian White

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies, and case reports, or reports of expert committees.

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Bruccoleri, R.E., Burns, M.J. (2017). Neuroleptic Malignant Syndrome. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_65

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