Idiosyncratic side effect primarily associated with antipsychotics
- muscular rigidity pyrexia,
- autonomic instability (unstable BP, tachycardia, increased sweating, increased salivation, urinary incontinence),
- decreased consciousness,
- increased creatinine kinase (CPK),
- low serum iron
Medical emergency that can lead to death.
- stop neuroleptic, treat hyperthermia aggressively.
- May need ICU.
- Dopamine agonists (dantrolene), benzodiazapines for agitation.
- Aggressive hydration with diuresis as myoglobin levels may result in renal failure.
Early recognition needed, however 10% fatal.