Curriculum · Mental Health / Psychiatry
Neuroleptic malignant syndrome
What it is
Neuroleptic malignant syndrome is one of the toxidromes. It is precipitated by dopamine antagonists, and three groups of findings make the picture: autonomic instability, neuromuscular findings, and mental status change. Its onset is given as variable on one page and as gradual rather than abrupt on another, and its course is prolonged.
Causes and risk
Dopamine antagonists precipitate it, the atypical antipsychotics among them. That precipitant is the first thing that sets it apart from serotonin syndrome, which is precipitated by serotonergic agents, usually the ingestion of two or more drugs such as MAOIs and SSRIs, and whose onset is abrupt rather than gradual, variable but usually less than 24 hours.