CARBAMAZEPINE IN THE TREATMENT OF NEUROLEPTIC MALIGNANT SYNDROME

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.