Neuroleptic malignant syndrome in children and adolescents on atypical antipsychotic medication: A review

Rachel Neuhut, Jean Pierre Lindenmayer, Raul Silva

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Objective: Neuroleptic malignant syndrome (NMS) is a severe iatrogenic complication of treatment with antipsychotic medication. The purpose of this report is to examine the published cases of NMS in children and adolescents receiving atypical antipsychotic medication and review early warning symptoms, risk factors, and treatment in this population. Method: An extensive review of the literature from 1990 to 2008 was conducted via computerized searches (PubMed and Ovid) to identify case reports. Descriptive statistics were employed to describe our findings. Results: There were 23 episodes in 20 subjects, with ages ranging from 11 to 18 years. Increased creatine phosphokinase (CPK) was the most common finding (100%), followed by fever (78%), tachycardia (74%), rigidity (70%), and altered mental status (61%). The number of NMS symptoms ranged from 1 to 11 (mean 4.7 ± 2.4) and positive laboratory findings ranged from 1 to 4 (2.2 ± 1). The duration of NMS (mean 6.1 ± 6.4 days) was one third of the duration associated with typical antipsychotics. Patients treated with bromocriptine had a shorter duration of illness, whereas the same was not true for those receiving dantrolene. In all cases, the NMS symptoms eventually resolved and there were no reported deaths or permanent sequelae. Conclusions: NMS is a serious condition. Symptom presentation related to atypical agents differs from that seen with older antipsychotic medications.

Original languageEnglish (US)
Pages (from-to)415-422
Number of pages8
JournalJournal of Child and Adolescent Psychopharmacology
Issue number4
StatePublished - Aug 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)


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