Carbamazepine in the treatment of neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse effect to neuroleptic drugs. We report on 2 cases where NMS dramatically improved with carbamazepine. Incidental removal and reapplication of carbamazepine attests to its effectiveness for this condition. A 34-year-old woman treate...

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Bibliographic Details
Published in:Biological psychiatry (1969) 1998-02, Vol.43 (4), p.303-305
Main Authors: Thomas, Pierre, Maron, Michel, Rascle, Claire, Cottencin, Olivier, Vaiva, Guillaume, Goudemand, Michel
Format: Article
Language:English
Subjects:
Adult
adverse event
affective disorder
Anticonvulsants
Anticonvulsants - therapeutic use
Antipsychotic Agents
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Biological and medical sciences
Carbamazepine
Carbamazepine - therapeutic use
Depressive Disorder
Depressive Disorder - complications
Depressive Disorder - drug therapy
Drug toxicity and drugs side effects treatment
Female
Haloperidol
Haloperidol - adverse effects
Haloperidol - therapeutic use
Humans
Life Sciences
Medical sciences
neuroleptic
Neuroleptic Malignant Syndrome
Neuroleptic Malignant Syndrome - drug therapy
Neurons and Cognition
Pharmacology. Drug treatments
Phenothiazines
Phenothiazines - adverse effects
Phenothiazines - therapeutic use
Toxicity: nervous system and muscle
treatment
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Summary:Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse effect to neuroleptic drugs. We report on 2 cases where NMS dramatically improved with carbamazepine. Incidental removal and reapplication of carbamazepine attests to its effectiveness for this condition. A 34-year-old woman treated for a major depressive disorder experienced NMS with a phenothiazine. Her condition dramatically improved in 8 hours after she was administered carbamazepine. Since carbamazepine was discontinued, NMS recurred in 10 hours and remitted anew within less than 24 hours after reintroduction. A 31-year-old woman experiencing a schizoaffective disorder displayed NMS with aphenothiazine and a butyrophenone. NMS completely resolved within 8 hours after she was administered carbamazepine. NMS recurred within 12 hours after carbamazepine discontinuation. These data thus account for a cause-effect relationship between carbamazepine administration and NMS relief and argue against the neuroleptic withdrawal to be responsible by itself for NMS relief.
ISSN:0006-3223
1873-2402
DOI:10.1016/S0006-3223(97)00450-2