Twenty neuroleptic rechallenges after neuroleptic malignant syndrome in 15 patients

Neuroleptic medication was reintroduced to 15 patients who had suffered an episode of neuroleptic malignant syndrome (NMS). Thirteen (87%) were eventually able to take neuroleptics again, indicating that they did not have an inherent intolerance. The authors analyzed the ability of patients to tolerate rechallenge according to the time of reintroduction after resolution of a previous episode and the relative neuroleptic potency and dosage compared with the initial episode. Successful rechallenge was highly significantly related to the time that had elapsed following resolution of the previous episode. The choice of a neuroleptic lower in potency and dosage than that which precipitated the original NMS episode was not significantly related to successful outcome.