What is the primary focus in the supportive care of a patient exhibiting symptoms of neuroleptic malignant syndrome?

The primary focus in the supportive care of a patient exhibiting symptoms of neuroleptic malignant syndrome (NMS) is on controlling fever and ensuring hydration. NMS is a serious reaction to antipsychotic medications characterized by hyperthermia, muscle rigidity, autonomic instability, and altered mental status. Supporting the patient involves addressing the most critical life-threatening symptoms, particularly hyperthermia, which can lead to severe complications, including multi-organ failure.

Hydration is equally important, as it helps support renal function and overall metabolic status, particularly in a patient experiencing muscle rigidity and elevated creatine phosphokinase levels, which can lead to rhabdomyolysis. Therefore, immediate attention to these physiological aspects is crucial in managing the patient's well-being during an episode of NMS.

While psychoeducation, referral to a specialist, and the immediate initiation of antipsychotic therapy can play important roles in the overall management of psychiatric disorders, they do not address the acute medical crisis posed by NMS. Therefore, these considerations are secondary to the urgent need for fever control and hydration in this situation.