Antidote: bromocriptine
Antidotal therapy for neuroleptic malignant syndrome has not been efficacious in controlled trials, although clinical experience and case reports support the use of the dopamine agonist, bromocriptine.
Consider bromocriptine for adults with severe or prolonged neuroleptic malignant syndrome, in consultation with a clinical toxicologist. A suitable regimen is:
bromocriptine 2.5 mg orally or via a nasogastric or orogastric tube, every 8 hours. Titrate the dose gradually according to clinical response (reduced temperature and muscle rigidity) up to 5 mg every 4 hours. neuroleptic malignant syndrome bromocriptine
Therapy is usually required for 5 to 10 days.
The dose of bromocriptine for children has not been established.
In severe and refractory cases, consider other therapies (eg dantrolene, electroconvulsive therapy) in consultation with a clinical toxicologist.