B. Spivak et al., NEUROLEPTIC MALIGNANT SYNDROME-ASSOCIATED WITH ABRUPT WITHDRAWAL OF ANTICHOLINERGIC AGENTS, International clinical psychopharmacology, 11(3), 1996, pp. 207-209
Neuroleptic malignant syndrome (NMS) is a severe side-effect of neurol
eptic treatment. It is usually related to hypodopaminergic activity. A
young schizophrenic patient who developed a typical episode of NMS du
ring abrupt withdrawal of long-acting neuroleptic combined with antich
olinergic treatment is described. NMS appeared following combined neur
oleptic/anticholinergic withdrawal and responded to procyclidine admin
istration. The appearance of NMS after discontinuation of antidopamine
rgic treatment seems to be in conflict with the hypodopaminergic theor
y of this adverse effect. It is suggested that simultaneous withdrawal
of both anticholinergic and neuroleptic medications, mainly long-acti
ng neuroleptics, seems to be a risk factor for NMS.