Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal idiosyncratic drug reaction usually defined as a complication of treatment with antipsychotics. It is manifested by altered mental status, hyperpyrexia, rigidity and autonomic instability. This syndrome occurs in response to administration of drugs that induce dopamine blockage.

Study the risk factors, diagnosis, treatment and complications of NMS, by performing a literature review.

Summarize the main aspects of NMS that may have importance in usual clinical practice.

PubMed was used to identify NMS articles published after 2000, associated with the MeSH terms “neuroleptic malignant syndrome” and “antipsychotic agents”.

NMS is not dose-related and its aetiology is still unknown. There are many risk factors associated with the syndrome, such as demographic, individual, genetic and environmental factors and medication. In order to evaluate the medical situation, an accurate clinical history and physical examination should be fulfilled. NMS is also characterized by changes in laboratory investigation. There are no patognomonic findings, thus other different diagnosis should be considered. Specific treatment remains controversial. Treatment should be individualized for each patient, regarding characteristics, duration and severity of the clinical signs and symptoms. Resolution is usually verified in one to two weeks. Though there are cases in which the symptoms persist and comorbid process may occur.

Although NMS is a rare complication of antipsychotic therapy, early diagnosis and treatment is essential to improve prognosis.