Thomas P, Maron M, Rascle C, Cottencin O, Vaiva G, Goudemand M
Department of Psychiatry, School of Medicine, Centre Hospitalier Regional et Universitaire, University of Lille, France.
Biol Psychiatry. 1998 Feb 15;43(4):303-5. doi: 10.1016/S0006-3223(97)00450-2.
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.
抗精神病药恶性综合征（NMS）是抗精神病药物一种潜在的致命不良反应。
我们报告2例使用卡马西平后NMS显著改善的病例。偶然停用及重新应用卡马西平证明了其对这种病症的有效性。
一名34岁患有重度抑郁症的女性在使用吩噻嗪类药物时出现NMS。在给予卡马西平8小时后她的病情显著改善。自从停用卡马西平后，NMS在10小时后复发，并在重新用药后不到24小时内再次缓解。一名31岁患有分裂情感性障碍的女性在使用吩噻嗪类药物和丁酰苯类药物时出现NMS。在给予卡马西平8小时内NMS完全缓解。停用卡马西平12小时后NMS复发。
这些数据证实了卡马西平给药与NMS缓解之间的因果关系，并反驳了仅抗精神病药物撤药就能缓解NMS的观点。
