Neuroleptic malignant syndrome susceptibility during extreme heat waves: A case report on a patient with schizophrenia

Abstract

This case report presents the clinical course of a 33-year-old male with a long-standing history of schizophrenia who presented to the psychiatric outpatient department. The patient exhibited symptoms including fever, confusion, rigidity, slurred speech, and generalized body swelling, prompting immediate admission for thorough evaluation and management. In response to the high fever and unclear etiology, our investigation broadened to consider the possible influence of heat wave exposure. The medical team took a comprehensive approach, suspending all current antipsychotic medications and implementing treatment modifications, fluid therapy, and symptomatic relief measures. The patient's condition improved significantly, leading to discharge after a nine-day hospitalization with a well-structured follow-up plan. This case highlights the importance of considering exposure to heat waves that can potentially increase susceptibility to adverse reactions to medications, including antipsychotics, thereby potentially elevating the risk of developing neuroleptic malignant syndrome (NMS) and also shows further need to explore the relationship between heat waves, antipsychotic medication, and the development of neuroleptic malignant syndrome.