Clinical and Forensic Experience

In my clinical and forensic experience, the emphasis on muscle rigidity is much too narrow. NMS can be accompanied by any kind of severe extrapyramidal reaction. Especially early in NMS, patients can display any of the wide array of neuroleptic-induced abnormal movements, including choreoathetoid movements, dystonia, and akinesia. Some cases look very much like severe TD, and often, the patients are left with persistent symptoms of TD. 

With the exception of the alteration in EEG activity, the scientific literature and my clinical and forensic work have confirmed that each of the previously mentioned antidepressant-induced phenomena can cause violent and suicidal behavior. However, my clinical and forensic experiences and reviews of the literature indicate that five syndromes encompass most of the phenomena and describe most of the individual cases ... 

---