A 30-year-old man who was recently staed on haloperidol 30mg/day developed hyperpyrexia, muscle rigidity, akinesia, mutism, sweating, tachycardia and increased blood pressure. The investigations showed increased WBC count, increased creatinine phosphokinase. There is no history of any other drug intake or any sign of infection. The most likely diagnosis: (A) Drug overdose, (B) Neuroleptic malignant syndrome, (C) Drug induce Parkinsonism, (D) Tardive dyskinesia
Answer is B. Neuroleptic Malignant Syndrome (Fever, EPS, High CPK, catatonic symptoms and autonomic dysfunction) Maximum with probably haloperidol (antipsychotic) Management: Bromocriptine, Dantrolene, Baclofen, General suppoive care. Add-on lorazepam, Occasionally ECT Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 179