It is a rare and unpredictable side-effect that has been associated with both first- and second-generation antipsychotics.1,2 It occurs in about 0.02–3% of individuals who are prescribed antipsychotics.3 NMS is generally characterised by rigidity fever, autonomic dysregulation, tremor, elevated creatine phosphokinase (CPK) levels and leucocytosis (Box 1).4 NMS is a potentially fatal adverse event. This evidence concerns the gene PIK3C2A and neuroleptic malignant syndrome.