Case reports of neuroleptic malignant syndrome in context of quetiapine use

Psychiatr Q. 2013 Dec;84(4):523-41. doi: 10.1007/s11126-013-9264-4.


A retrospective analysis was followed on 20 case reports covering the possible correlation between the atypical antipsychotic, quetiapine, and neuroleptic malignant syndrome (NMS), determined by the study of 7 different NMS criteria guidelines. A great majority (19) of the case studies did not meet the requirements of all 7 guidelines, frequently due to unreported information. Nor was quetiapine proven to be the sole cause of the possible NMS in the two age groups investigated. Only one case was found to have no other medication or medical conditions confounding the relationship of quetiapine and NMS symptoms, and that case was in the context of a significant quetiapine overdose. The other 19 cases demonstrated the difficulty of identifying the cause of NMS when polypharmacy and other medical conditions are involved. The authors note the need for caution in deciding both the presence of NMS and the causal factors of the symptoms.

MeSH terms

  • Adult
  • Age Factors
  • Antiparkinson Agents / adverse effects
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects*
  • Diagnosis, Differential
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dibenzothiazepines / administration & dosage
  • Dibenzothiazepines / adverse effects*
  • Dose-Response Relationship, Drug
  • Fever / chemically induced
  • Guideline Adherence
  • Humans
  • Mental Disorders / drug therapy*
  • Middle Aged
  • Muscle Rigidity / chemically induced
  • Neuroleptic Malignant Syndrome* / diagnosis
  • Neuroleptic Malignant Syndrome* / etiology
  • Neuroleptic Malignant Syndrome* / physiopathology
  • Practice Guidelines as Topic
  • Quetiapine Fumarate
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Serotonin Syndrome / diagnosis
  • Serotonin Syndrome / etiology
  • Serotonin Syndrome / physiopathology
  • Young Adult


  • Antiparkinson Agents
  • Antipsychotic Agents
  • Dibenzothiazepines
  • Serotonin Uptake Inhibitors
  • Quetiapine Fumarate