Background: Neuroleptic malignant syndrome (NMS) is a potentially leth
al 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 t
his condition. Results: A 34-year-old woman treated for a major depres
sive disorder experienced NMS with a phenothiazine, Her condition dram
atically improved in 8 hours after she was administered carbamazepine.
Since carbamazepine was discontinued, NMS recurred in 10 hours and re
mitted anew within less than 24 hours after reintroduction. A 31-year-
old woman experiencing a schizoaffective disorder displayed NMS with a
phenothiazine and a butyrophenone. none. NMS completely resolved withi
n 8 hours after she was administered carbamazepine. NMS recurred withi
n 12 hours after carbamazepine discontinuation. Conclusions: These dat
a thus account for a cause-effect relationship between carbamazepine a
dministration and NMS relief and argue against the neuroleptic withdra
wal to be responsible by itself for NMS relief. (C) 1998 Society of Bi
ological Psychiatry.