‘Neuroleptic Malignant Syndrome’ Without Neuroleptics

  title={‘Neuroleptic Malignant Syndrome’ Without Neuroleptics},
  author={Daniel Brennan and Michael P. Mac Manus and John Howe and James McLoughlin},
  journal={British Journal of Psychiatry},
  pages={578 - 579}
SIR: Depersonalisation/derealisation are common symptoms of anxiety and of affective disorder, and are not uncommon features of other psychiatric syn dromes. They are also common in various organic states (e.g. hypoglycaemia) and are frequently likened by patients to dreaming, which occurs at a time of demonstrable alteration in cerebral activity. Furthermore, these phenomena are disorders of per ception, which suggests some organic basis. Is it possible that depersonalisation/derealisation are… 
The serotonin syndrome: Definition and eause
An examination of the latest literature about SS and neuroleptic malignant syndrome indicates that the two syndromes are of the same nature, induced by an imbalance between serotonin and dopamine in the brainstem; other neurotransmitters may also form part of the pathogenesis of the syndrome.
Neuroleptic malignant syndrome in Parkinson's disease after withdrawal or alteration of dopaminergic therapy.
An understanding of the role of brain dopamine in the pathogenesis of neuroleptic malignant syndrome and an appreciation of the great variety of drugs whose manipulation can result in this potentially fatal syndrome will aid its proper and timely recognition.
Neurotoxic Syndrome Associated with Risperidone and Fluvoxamine
Clinicians should be aware of potentially serious adverse reactions that may occur during concomitant treatment with antipsychotics and selective serotonin-reuptake inhibitors as well as other considerations in formulating treatment for neurotoxic syndromes.
Four cases of neuroleptic malignant syndrome.
The neuroleptic malignant syndrome is reported, with four cases of NMS; one following levodopa/bromocriptine withdrawal, two related to Neuroleptic administration and one following heroin use.
The Serotonin Syndrome
Because fatalities and severe complications have accompanied the serotonin syndrome, the previously described drug combinations should be used cautiously or not at all.
Neuroleptic malignant syndrome and serotonin syndrome.
Neuroleptic Malignant Syndrome: A Review for Intensivists
Diagnostic criteria, risk factors, and treatment options for NMS are discussed; case examples are provided.
The Most Common Drug Interactions Associated With the Serotonin Syndrome in 38 Patients in 12 Reports Reference
The serotonin syndrome is a toxic condition requiring heightened clinical awareness for prevention, recognition, and prompt treatment, and further work is needed to establish the diagnostic criteria, incidence, and predisposing factors.
Recognition and Treatment of the Catatonic Syndrome
The literature on the treatment of the catatonic syndrome is reviewed, and a suggested approach to treatment and management of catatonia patients in the intensive care unit is provided.


The neuroleptic malignant syndrome--a review.
  • W. GibbA. Lees
  • Medicine, Psychology
    The Quarterly journal of medicine
  • 1985
The neuroleptic malignant syndrome (NMS) is an uncommon disorder characterised by muscular stiffness and hyperthermia. It is caused by the administration of neuroleptics or by the acute withdrawal of
Neuroleptic malignant syndrome.
  • J. Levenson
  • Medicine, Psychology
    The American journal of psychiatry
  • 1985
Demographic and clinical features, diagnosis, treatment, outcome, and pathophysiology are critically reviewed, and a new set of diagnostic criteria, incorporating physical signs and routine laboratory tests, is proposed.
Fatal hyperpyrexia after withdrawal of levodopa
The rapid decrease in dopaminergic activity may have been important in causing the neuroleptic malignant syndrome in a patient affected with idiopathic Parkinson's disease and levodopa-induced dyskinesias.
Case report of neuroleptic malignant syndrome associated with withdrawal from amantadine.
This case report of neuroleptic malignant syndrome following withdrawal of Neuroleptics and amantadine suggests that dopamine agonists should not be discontinued in hyperpyrexic patients at risk for this syndrome.
Hyperthermia after discontinuance of levodopa and bromocriptine therapy
Impaired nigrostriatal, hypothalamic, and mesolimbic dopaminergic functions could be involved in pathogenesis and hyperthermia is described as a complication after discontinuance of antiparkinsonian treatment with levodopa/carbidopa and bromocriptine.
Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome.
It is proposed that NMS may be caused by levodopa withdrawal in Parkinson's disease, and that it is withdrawal of dopaminergic drive that causes the syndrome.