In suspected neuroleptic malignant syndrome, what is the immediate priority?

• A. Stop the antipsychotic and obtain CBC and CPK
• B. Administer more antipsychotics
• C. Increase hydration only
• D. Do nothing until doctor arrives

Answer: (A)

Immediate priority in suspected neuroleptic malignant syndrome is to stop the offending antipsychotic right away and obtain CBC and CPK to gauge severity. NMS can progress rapidly to life-threatening hyperthermia, rigidity, and autonomic instability, so removing the trigger is the fastest way to prevent further harm. The CBC and CPK results help assess the body's response and risk of complications like rhabdomyolysis, guiding urgent supportive care such as cooling and aggressive IV fluids. Administering more antipsychotics would worsen the situation, and waiting for a doctor or focusing only on hydration would not address the urgent need to halt the cause and assess damage.