Which of the following is a red flag for potential medical complications in antipsychotic therapy?

• A. Weight gain
• B. Fever with rigidity (NMS)
• C. Dehydration
• D. Sneezing

Answer: (B)

Fever with severe muscle rigidity points to Neuroleptic Malignant Syndrome, a rare but life-threatening reaction to antipsychotics. NMS typically shows high fever, marked rigidity, altered mental status, and autonomic instability (like fluctuating blood pressure or heart rate). Because it can escalate quickly to organ failure, it’s a medical emergency: stop the antipsychotic immediately, begin aggressive cooling and IV fluids, monitor closely, and seek urgent medical care. Treatments such as dantrolene or bromocriptine may be used depending on the case, and labs often reveal elevated CK and renal strain from muscle breakdown.

Weight gain is a common metabolic side effect but does not signal an acute, dangerous complication. Dehydration can be serious but isn’t the specific red-flag indicator for a potentially fatal reaction to antipsychotics like NMS. Sneezing isn’t related to a dangerous antipsychotic complication.