NEUROLEPTIC MALIGNANT SYNDROME-ASSOCIATED WITH ABRUPT WITHDRAWAL OF ANTICHOLINERGIC AGENTS

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.