Editing Neuroleptic malignant syndrome (section)

===Risk factors===
The use of antipsychotics as well as how this class of medications is used is one of the most common risk factors for NMS. Use of high-potency antipsychotics, a rapid increase in the dosage of antipsychotics, use of long-acting forms of antipsychotics (such as haloperidol) or injectable formulations, or using multiple antipsychotics are all known to increase the risk of developing NMS.<ref>{{cite book | vauthors = Miller CS, Wiese JG | date = 2017 | chapter = Hyperthermia and fever. | veditors = McKean SC, Ross JJ, Dressler DD, Scheurer DB | title = Principles and Practice of Hospital Medicine | edition = 2nd | publisher = McGraw Hill | url = https://accessmedicine.mhmedical.com/content.aspx?bookid=1872&sectionid=146976769 | isbn = 978-0-07-184313-3 }}</ref><ref>{{cite journal | vauthors = Keck PE, Pope HG, Cohen BM, McElroy SL, Nierenberg AA | title = Risk factors for neuroleptic malignant syndrome. A case-control study | journal = Archives of General Psychiatry | volume = 46 | issue = 10 | pages = 914–918 | date = October 1989 | pmid = 2572206 | doi = 10.1001/archpsyc.1989.01810100056011 }}</ref><ref name="Wijdicks 2024" /> Dehydration is a risk factor for the development of NMS.<ref name="Wijdicks 2024" /> There appears to be no relationship between duration of therapy and the development of NMS.<ref name="Trollor_2009" />

Use of the following agents is most commonly associated with the development of NMS:<ref name=Simon2022/>
* Typical antipsychotics: e.g. haloperidol, chlorpromazine.<ref>{{cite book | chapter = Key medications & interventions in psychiatry. | vauthors = Huppert LA, Dyster TG | date = 2021 | title = Huppert's Notes: Pathophysiology and Clinical Pearls for Internal Medicine. | publisher = McGraw Hill | chapter-url = https://accessmedicine.mhmedical.com/content.aspx?bookid=3072&sectionid=257403886 | isbn = 978-1-260-47007-9 }}</ref> 
* Anti-dopaminergic antiemetics: e.g. droperidol 
* Withdrawal of dopaminergic agents: e.g. [[levodopa]], [[amantadine]]<ref>{{cite book | chapter = Thermoregulation, hypothermia, & malignant hyperthermia. | vauthors = Butterworth IV JF, Mackey DC, Wasnick JD | date = 2022 | title = Morgan & Mikhail's Clinical Anesthesiology | edition = 7th | publisher = McGraw Hill | url = https://accessmedicine.mhmedical.com/content.aspx?bookid=3194&sectionid=266525430 | isbn = 978-1-260-47379-7 }}</ref>

It has been purported that there is a genetic risk factor for NMS.<ref>{{cite journal | vauthors = Velamoor VR | title = Neuroleptic malignant syndrome. Recognition, prevention and management | journal = Drug Safety | volume = 19 | issue = 1 | pages = 73–82 | date = July 1998 | pmid = 9673859 | doi = 10.2165/00002018-199819010-00006 | s2cid = 23303714 }}</ref> In one study, identical twins presented with NMS, and a mother and two of her daughters have presented with NMS in another case.<ref>{{cite journal | vauthors = Otani K, Horiuchi M, Kondo T, Kaneko S, Fukushima Y | title = Is the predisposition to neuroleptic malignant syndrome genetically transmitted? | journal = The British Journal of Psychiatry | volume = 158 | issue = 6 | pages = 850–853 | date = June 1991 | pmid = 1678666 | doi = 10.1192/bjp.158.6.850 | s2cid = 23185221 }}</ref>

Demographically, it appears that males, especially those under forty, are at greatest risk for developing NMS, although it is unclear if the increased incidence is a result of greater antipsychotic use in men under forty.<ref name=benzer/> It has also been suggested that postpartum women may be at a greater risk for NMS.<ref>{{cite journal | vauthors = Alexander PJ, Thomas RM, Das A | title = Is risk of neuroleptic malignant syndrome increased in the postpartum period? | journal = The Journal of Clinical Psychiatry | volume = 59 | issue = 5 | pages = 254–255 | date = May 1998 | pmid = 9632037 | doi = 10.4088/JCP.v59n0509a | doi-access = free }}</ref>

Antipsychotic use in those with [[Lewy body dementia]] is a risk factor for NMS. These people are extremely sensitive to antipsychotics. As a result, antipsychotics should be used cautiously in all cases of dementia.<ref>{{cite journal | vauthors = Steinberg M, Lyketsos CG | title = Atypical antipsychotic use in patients with dementia: managing safety concerns | journal = The American Journal of Psychiatry | volume = 169 | issue = 9 | pages = 900–906 | date = September 2012 | pmid = 22952071 | pmc = 3516138 | doi = 10.1176/appi.ajp.2012.12030342 }}</ref>