The evidence for the hypothesis that dopamine blockade is central to neuroleptic malignant syndrome (NMS) is mostly circumstantial, but is related to the fact that NMS is precipitated by antipsychotics that block dopamine receptors. Dopamine receptors in the hypothalamus are integral to the regulation of body temperature and their blockade results in hyperthermia and autonomic instability. The patient with NMS classically develops worsening altered mental status over the course of several days after, or during, treatment with an antipsychotic medication. The most important aspect of treatment for NMS is the discontinuation of the offending medication (or restarting a previously held dopamine agonist) followed by supportive care. Benzodiazepines should be used as a component of supportive care in patients with increased sympathetic tone. Dopamine agonists such as bromocriptine and amantadine have been advocated as possible therapies based on a theory that NMS is primarily caused by dopamine blockade.