Mortality from neuroleptic malignant syndrome

J Clin Psychiatry. 1989 Jan;50(1):18-25.


The authors assess the mortality from the neuroleptic malignant syndrome (NMS) based on an exhaustive review of 202 published case reports, including a differential assessment of risk factors and protective factors. The results indicate a significant (p less than .05) decrease in mortality since 1984 (11.6% vs. 25% before 1984), which occurs independently of the therapeutic use of dopamine agonists and dantrolene. A significantly (p less than .001) lower rate of mortality from haloperidol-induced NMS (7%) and a high rate of mortality (38.5%) among patients with organic brain syndrome were also found. Myoglobinemia and renal failure are strong predictors of mortality, representing a mortality risk of approximately 50%. The authors discuss the implications of these findings.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Dantrolene / therapeutic use
  • Dopamine Agents / therapeutic use
  • Female
  • Haloperidol / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Neuroleptic Malignant Syndrome / drug therapy
  • Neuroleptic Malignant Syndrome / etiology
  • Neuroleptic Malignant Syndrome / mortality*
  • Risk Factors
  • Substance-Related Disorders / etiology
  • Substance-Related Disorders / mortality


  • Dopamine Agents
  • Dantrolene
  • Haloperidol