Carbamazepine in the treatment of neuroleptic malignant syndrome.
BACKGROUND
Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse effect to neuroleptic drugs.


METHODS
We report on 2 cases where NMS dramatically improved with carbamazepine. Incidental removal and reapplication of carbamazepine attests to its effectiveness for this condition.


RESULTS
A 34-year-old woman treated for a major depressive disorder experienced NMS with a phenothiazine. Her condition dramatically improved in 8 hours after she was administered carbamazepine. Since carbamazepine was discontinued, NMS recurred in 10 hours and remitted anew within less than 24 hours after reintroduction. A 31-year-old woman experiencing a schizoaffective disorder displayed NMS with aphenothiazine and a butyrophenone. NMS completely resolved within 8 hours after she was administered carbamazepine. NMS recurred within 12 hours after carbamazepine discontinuation.


CONCLUSIONS
These data thus account for a cause-effect relationship between carbamazepine administration and NMS relief, and argue against the neuroleptic withdrawal to be responsible by itself for NMS relief.
Thomas
P
P
Department of Psychiatry, School of Medicine, Centre Hospitalier Regional et Universitaire, University of Lille, France.
Maron
M
M
Rascle
C
C
Cottencin
O
O
Vaiva
G
G
Goudemand
M
M
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000188:drug therapy*; D010640:Phenothiazines / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D010640:Phenothiazines; D002220:Carbamazepine; C028457:cyamemazine; D006220:Haloperidol