Neuroleptic Malignant Syndrome: Looked at from the Diagnostic and Therapeutic Perspectives in a General Hospital Setting

Neuroleptic malignant syndrome is a rare life-threatening condition, usually induced by typical and
atypical antipsychotics. A middle-aged woman with bipolar disorder and acute back pain due to
multiple falls was admitted to the trauma ward of a general hospital. After 3 days, she suddenly
developed signs and symptoms of neuroleptic malignant syndrome possibly caused by injectable
haloperidol given intramuscularly as “pro re nata” (as the medication needed), although the additional
role of olanzapine could not be ruled out. A 3-day delayed diagnosis of neuroleptic malignant
syndrome led to serious complications, which could be prevented by its prompt management
contingent on its early diagnosis, even in the absence of certain diagnostic criteria. Although she
improved substantially with treatment interventions and continued to have dialysis, she died later due
to renal complications. The mental health professionals must avoid administering antipsychotic
medications as needed among such vulnerable psychiatric patients admitted to general hospitals
across the board.