Which class of drugs is associated with neuroleptic malignant syndrome characterized by muscle rigidity and hyperthermia?

Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that is primarily associated with the use of antipsychotic medications, particularly the first-generation (typical) antipsychotics. NMS is characterized by a triad of symptoms: severe muscle rigidity, hyperthermia, and altered mental status. Additional features may include autonomic instability (such as fluctuating blood pressure and tachycardia) and increased creatine kinase levels due to muscle breakdown.

Antipsychotics function by blocking dopamine receptors in the brain, which is believed to lead to the development of NMS in susceptible individuals. The risk is particularly high during the initiation of treatment, after a dosage increase, or after the patient has missed a dose and then resumes the medication.

While other drug classes can have their own adverse effects, they do not typically cause NMS. For instance, antidepressants may result in other syndromes like serotonin syndrome, stimulants can lead to sympathomimetic effects, and opioids primarily cause respiratory depression and constipation. Therefore, understanding the association of neuroleptic malignant syndrome with antipsychotic medications is critical for appropriate recognition and management of this serious condition.