Drug Side Effects | Neuroleptic Malignant Syndrome

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome is an adverse reaction to neuroleptic or antipsychotic drugs. It can present with a combination of hyperthermia, autonomic dysregulation, and rigidity. These three conditions alone are quite serious and their combination makes it even more so. Although it is a rare condition, it is the most serious of neuroleptic movement disorders and, in most cases, represents a neurologic emergency. The low incidence of neuroleptic malignant syndrome makes studying its symptoms, predisposing conditions, and clinical features quite challenging. The syndrome usually occurs in adult males below 40 years of age, although studies do not completely rule out the possibility of it occurring in children. Clinicians are recommended to be watchful of the symptoms in children because they will be consistent with those experienced by adults if they occur. Neuroleptic malignant syndrome can be life-threatening if not managed properly.

Symptoms of Neuroleptic Malignant Syndrome

At the onset, the first symptom to usually develop is muscular cramps, followed by fever and unstable blood pressure. Once symptoms appear, the progress is quick and peak intensity can be reached in as little as three days, with symptoms lasting to as long as 40 days. It is possible to recover completely from the syndrome, but some may end up with permanent dementia, Parkinsonism, or ataxia. Dehydration, thyrotoxicosis, hyponatremia, affective disorders, and physical exhaustion are conditions that make an individual predisposed to neuroleptic malignant syndrome. Other possible symptoms include:

  • Autonomic instability
  • Muscle tremors
  • Fever
  • Diaphoresis
  • Confusion
  • Altered consciousness
  • Leukocytosis


People being treated for neuroleptic malignant syndrome are generally put under intensive care. The fever is treated immediately while antipsychotic drugs are discontinued for the time being. A muscle relaxant may be prescribed to the patient to relieve muscle tremors and cramps. Dopamine agonists have also been reported as useful in the management of the syndrome. As with all other conditions, and especially with neuroleptic malignant syndrome, early recognition is vital and can mean the difference between full recovery and a lifetime of Parkinsonism or dementia. With an aggressive treatment regimen in place, the syndrome can be resolved within 3 days.

Drug Side Effects

Reglan neuroleptic malignant syndrome is one of several Reglan side effects of the antipsychotic drug Reglan or metoclopramide. Today, Reglan is usually prescribed as a short-term treatment for acid reflux or heartburn. Reglan neuroleptic malignant syndrome is just one of several serious side effects caused by Reglan.