Antipsychotics: neuroleptic malignant syndrome: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Psychiatry · Antipsychotics: neuroleptic malignant syndrome

Sample item

Two days after haloperidol was increased, a patient has temperature 40 C, lead-pipe rigidity, confusion, autonomic instability and CK of 8000 U/L. First steps include stopping the antipsychotic and giving:

ACyproheptadine aloneBBenztropine aloneCIncreased haloperidolDDantrolene or bromocriptine with supportive care

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Dantrolene or bromocriptine with supportive care

Neuroleptic malignant syndrome is a life-threatening reaction to dopamine antagonists with hyperthermia, rigidity, altered sensorium and raised CK. Treatment is stopping the drug, cooling, fluids, and dantrolene or bromocriptine in severe cases.

Option by option

A. Cyproheptadine alone
Cyproheptadine is used for serotonin syndrome.
B. Benztropine alone
Anticholinergics do not treat NMS and may worsen hyperthermia.
C. Increased haloperidol
More haloperidol would worsen NMS.
D. Dantrolene or bromocriptine with supportive care (correct)
Correct. Dantrolene or bromocriptine plus supportive care is the treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Dantrolene or bromocriptine with supportive care. Neuroleptic malignant syndrome is a life-threatening reaction to dopamine antagonists with hyperthermia, rigidity, altered sensorium and raised CK.

Why is "Cyproheptadine alone" not the answer?

Cyproheptadine is used for serotonin syndrome.

Why is "Benztropine alone" not the answer?

Anticholinergics do not treat NMS and may worsen hyperthermia.

Why is "Increased haloperidol" not the answer?

More haloperidol would worsen NMS.

What concept does this question test?

It tests Antipsychotics: neuroleptic malignant syndrome in Psychiatry. Treatment is stopping the drug, cooling, fluids, and dantrolene or bromocriptine in severe cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antipsychotics: neuroleptic malignant syndrome?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.