Neuroleptic Malignant Syndrome: Neuroleptic Rechallenge After Electroconvulsive Therapy

The necessity of neuroleptic rechallenge in patients who have experienced neuroleptic malignant syndrome (NMS) has been discussed in recent articles. Electroconvulsive therapy (ECT) has been proposed as an alternative treatment to neuroleptics. In cases where ECT fails, neuroleptic rechallenge remains the only alternative. A case of NMS is reported with successful reintroduction of neuroleptics after an ECT course. Four prior rechallenges with neuroleptics before ECT had failed, and NMS recurred. ECT may change the reaction to neuroleptics.