Clinical pharmacy
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A patient who developed neuroleptic malignant syndrome (NMS) from the use of several neuroleptic agents and the therapeutic interventions used to reverse the syndrome are described, and the clinical presentation and treatment of NMS are reviewed. Fever, leukocytosis, seizures, delirium, and elevated serum creatine phosphokinase levels developed in a 17-year-old girl who was receiving perphenazine and haloperidol. The patient was admitted to a hospital for treatment of atypical psychosis and received haloperidol and, later, thioridazine. ⋯ Bromocriptine, amantadine, dantrolene sodium, and electroconvulsive therapy have been used effectively in the treatment of NMS. NMS is a rare but potentially fatal adverse drug reaction that occurs in situations that make diagnosis difficult. Dramatic, favorable responses can be achieved with early diagnosis and appropriate treatment.