Neuroleptic Malignant Syndrome (NMS)

Neuroleptic Malignant Syndrome (NMS) is a rare but life-threatening condition primarily associated with the administration of neuroleptic medications, which are commonly used in the treatment of psychiatric disorders. These medications function primarily by antagonizing dopamine receptors in the brain. NMS can also occur following the abrupt withdrawal of dopaminergic drugs.

The syndrome is characterized by a distinctive constellation of symptoms, notably severe muscle rigidity, fever, altered mental status, and autonomic dysregulation. The onset of these symptoms typically occurs within days of initiating or increasing the dosage of neuroleptic medication, although it can also arise from long-term use.

Diagnosis of NMS is primarily clinical, based on the presentation of key symptoms and the patient's drug history. The DSM-V outlines specific criteria for diagnosis, requiring the presence of major symptoms like severe muscle rigidity and fever, along with additional symptoms like diaphoresis, dysphagia, and altered consciousness.

Early recognition and treatment of NMS are crucial. The management typically involves the immediate cessation of the offending agent, supportive care, and in some cases, the use of specific pharmacological agents.