Prospective evaluation of circulatory levels of catecholamines and serotonin in neuroleptic malignant syndrome.

2000 
Objective: Neuroleptic malignant syndrome (NMS) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. The objective of the present study was to evaluate prospectively the circulatory levels of serotonin (5-HT), epinephrine (E) and dopa in patients suffering from NMS. Method: Platelet-poor plasma (PPP) levels of serotonin, epinephrine and dopa in eight NMS patients were measured twice: in the acute state and in the state of remission. Results: PPP dopa concentration was significantly lower in acute NMS state compared to the remission state (P=0.023). In contrast, PPP E level was significantly higher (P=0.019) in the acute NMS state and PPP 5-HT concentrations in the acute state tended to be higher than those at remission (P=0.078). 5-HT/dopa ratio was significantly higher in the acute NMS (P=0.015). Conclusion: These results may reflect reduction in dopaminergic function and increase in adrenergic and serotonergic activity in the acute NMS state.
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