Unmasking neuroleptic malignant syndrome: An integrated behavioral health team's role in clinical diagnosis and care continuity

ABSTRACT: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neurological emergency triggered by an adverse reaction to dopamine receptor antagonists, particularly antipsychotics. Its clinical significance lies in both its high mortality risk and the diagnostic and therapeutic challenges NMS presents. Integrated Behavioral Health (IBH) models emphasize collaborative, interdisciplinary care that unites medical and mental health providers to address the full spectrum of patient needs. Nurse practitioners (NPs), with their holistic and patient-centered framework, are uniquely positioned to lead and contribute meaningfully within IBH teams. This case highlights the application of an NP-led IBH team in the successful early recognition of NMS in a resource-limited homeless shelter setting. Despite the diagnostic complexity and significant fatality risk associated with NMS, the NP's role was central in diagnosis with timely escalation of care, care coordination, and continuity of treatment through an integrated approach.