National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Neuroleptic malignant syndrome


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Neuroleptic malignant syndrome is a rare neurological condition that is caused by an adverse reaction to neuroleptic (tranquilizer) or antipsychotic drugs. These drugs are commonly prescribed for the treatment of schizophrenia and other neurological, mental, or emotional disorders. Affected people may experience high fever, muscle stiffness, sweating, unstable blood pressure, altered mental status, and autonomic dysfunction. In most cases, the condition develops within the first 2 weeks of treatment with the drug; however, it may develop any time during the therapy period. The exact underlying cause of neuroleptic malignant syndrome is unknown. In some cases, more than one family member can be affected which suggests there may be a genetic component. Upon diagnosis of the condition, the neuroleptic or antipsychotic drug is generally discontinued under a physician's supervision. Medications and/or other interventions may also be recommended to manage symptoms.[1][2][3]
Last updated: 7/14/2015

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Abnormal autonomic nervous system physiology 0012332
Extrapyramidal muscular rigidity 0007076
Fever 0001945
Hyperhidrosis
Excessive sweating
Increased sweating
Profuse sweating
Sweating
Sweating profusely
Sweating, increased
[ more ] 		0000975
Mutism
Inability to speak
Muteness
[ more ] 		0002300
30%-79% of people have these symptoms
Drooling
Dribbling
0002307
Dysphagia
Poor swallowing
Swallowing difficulties
Swallowing difficulty
[ more ] 		0002015
Elevated serum creatine kinase
Elevated blood creatine phosphokinase
Elevated circulating creatine phosphokinase
Elevated creatine kinase
Elevated serum CPK
Elevated serum creatine phosphokinase
High serum creatine kinase
Increased CPK
Increased creatine kinase
Increased creatine phosphokinase
Increased serum CK
Increased serum creatine kinase
Increased serum creatine phosphokinase
[ more ] 		0003236
Fatigue
Tired
Tiredness
[ more ] 		0012378
Leukocytosis
Elevated white blood count
High white blood count
Increased blood leukocyte number
[ more ] 		0001974
Metabolic acidosis 0001942
Muscle spasm 0003394
Tachycardia
Fast heart rate
Heart racing
Racing heart
[ more ] 		0001649
Tremor 0001337
5%-29% of people have these symptoms
Acute kidney injury 0001919
Agitation 0000713
Anxiety
Excessive, persistent worry and fear
0000739
Aspiration pneumonia 0011951
Chorea 0002072
Coma 0001259
Dehydration 0001944
Delirium 0031258
Elevated alkaline phosphatase
Greatly elevated alkaline phosphatase
High serum alkaline phosphatase
Increased alkaline phosphatase
Increased serum alkaline phosphatase
[ more ] 		0003155
Elevated hepatic transaminase
High liver enzymes
0002910
Encephalopathy 0001298
Hyperkalemia
Elevated serum potassium levels
0002153
Hypernatremia
High blood sodium levels
0003228
Hyperphosphatemia
High blood phosphate levels
0002905
Hypertensive crisis 0100735
Hyperuricemia
High blood uric acid level
0002149
Hypocalcemia
Low blood calcium levels
0002901
Hypomagnesemia
Low blood magnesium levels
0002917
Hyponatremia
Low blood sodium levels
0002902
Hypotension
Low blood pressure
0002615
Increased lactate dehydrogenase level 0025435
Myoglobinuria 0002913
Nasogastric tube feeding 0040288
Nausea 0002018
Oculogyric crisis 0010553
Proteinuria
High urine protein levels
Protein in urine
[ more ] 		0000093
Pulmonary embolism
Blood clot in artery of lung
0002204
Rhabdomyolysis
Breakdown of skeletal muscle
0003201
Rigors 0025145
Thrombocytosis
Increased number of platelets in blood
0001894
Urinary incontinence
Loss of bladder control
0000020
Vomiting
Throwing up
0002013
1%-4% of people have these symptoms
Bradycardia
Slow heartbeats
0001662
Hypothermia
Abnormally low body temperature
0002045
Sepsis
Infection in blood stream
0100806
Thrombocytopenia
Low platelet count
0001873
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Last updated: 7/1/2020

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
The differential diagnosis is of prime importance. It includes malignant hyperthermia of anesthesia, serotonin syndrome, parkinsonism hyperpyrexia syndrome, heat stroke, idiopathic malignant catatonia, infections (sepsis, meningitis, encephalitis), autoimmune disorders (limbic encephalitis with NMDA receptor antibodies, lupus cerebritis) delirium tremens, status epilepticus, salicylate poisoning, endocrinopathies, stroke, and brain trauma.
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Neuroleptic malignant syndrome. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Merck Manual for health care professionals provides information on Neuroleptic malignant syndrome.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Neuroleptic malignant syndrome. Click on the link to view a sample search on this topic.

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  1. Neuroleptic Malignant Syndrome Information Page. National Institute for Neurological Disorders and Stroke. April 2014; http://www.ninds.nih.gov/disorders/neuroleptic_syndrome/neuroleptic_syndrome.htm.
  2. Theodore I Benzer, MD, PhD. Neuroleptic Malignant Syndrome. Medscape Reference. February 2015; http://emedicine.medscape.com/article/816018-overview#a4.
  3. Eelco FM Wijdicks, MD. Neuroleptic malignant syndrome. UpToDate. May 2014; Accessed 7/14/2015.