Which drugs can cause Neuroleptic Malignant Syndrome?

· Regional Drug and Therapeutics Centre

This updated Medicines Q&A seeks to identify some drugs which have been associated with Neuroleptic Malignant Syndrome.

  • Neuroleptic Malignant Syndrome (NMS) is a rare but potentially fatal adverse reaction to drugs.
  • It is most commonly seen with antipsychotic agents.
  • Atypical agents may have a lower incidence of NMS than typical agents, although this is yet to be proved and case reports of NMS associated with most antipsychotic agents continue to emerge in the medical literature.
  • NMS associated with clozapine may present atypically.
  • It may also rarely be associated with withdrawal or reduction of dose of dopamine agonists such as levodopa, amantadine and bromocriptine.
  • Metoclopramide and domperidone have reportedly caused NMS in some patients.
  • Combinations of antipsychotics, or antipsychotics with lithium or antidepressants, may increase the risk of NMS developing.