title: Neuroleptic malignant syndrome associated with abrupt withdrawal of anticholinergic agents.
abstract: Neuroleptic malignant syndrome (NMS) is a severe side-effect of neuroleptic treatment. It is usually related to hypodopaminergic activity. A young schizophrenic patient who developed a typical episode of NMS during abrupt withdrawal of long-acting neuroleptic combined with anticholinergic treatment is described. NMS appeared following combined neuroleptic/ anticholinergic withdrawal and responded to procyclidine administration. The appearance of NMS after discontinuation of antidopaminergic treatment seems to be in conflict with the hypodopaminergic theory of this adverse effect. It is suggested that simultaneous withdrawal of both anticholinergic and neuroleptic medications, mainly long-acting neuroleptics, seems to be a risk factor for NMS.
authors.affiliation: Research Unit, Ness Ziona Government Psychiatric Hospital, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Spivak
authors.forename: N
authors.initials: N
authors.lastname: Gonen
authors.forename: R
authors.initials: R
authors.lastname: Mester
authors.forename: E
authors.initials: E
authors.lastname: Averbuch
authors.forename: S
authors.initials: S
authors.lastname: Adlersberg
authors.forename: A
authors.initials: A
authors.lastname: Weizman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005476:Fluphenazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D010395:Penfluridol / Q000627:therapeutic use; D011352:Procyclidine / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome; D014282:Trihexyphenidyl / Q000009:adverse effects*
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018727:Muscarinic Antagonists; D010395:Penfluridol; D014282:Trihexyphenidyl; D011352:Procyclidine; C011825:fluphenazine depot; D005476:Fluphenazine