NEUROLEPTIC MALIGNANT SYNDROME UNDER TREA TMENT WITH ANTIDEPRESSANTS

The neuroleptic malignant syndrome (NMS) is a rare complication in the treatment of neuroleptics. The pathophysiology is not fully known. A dopaminergic transmission block in the basal ganglia and the hypothala mus is thought to be the pathophysiological mechanism of NMS. There ar e some findings against the single role of dopamine receptor blockade: NMS is rare under neuroleptic treatment, although a strong dopamine r eceptor blockade is found even with a low dosis of neuroleptics, NMS c an develop even after longterm treatment with neuroleptics and is not improved by dopamine agonists within the expected period. NMS may even develop when neuroleptics are reduced, Several cases have been report ed of NMS precipitated by medication without a direct effect on dopami nergic system. Only rare case reports describe NMS under antidepressan ts, We report on all cases of NMS associated with antidepressants and present the different pathophysiological hypotheses on the precipitati on of NMS.