Psychotic exacerbations produced by neuroleptics

Thirteen schizophrenic patients who developed abnormal psychotic behavior as an adverse reaction to a neuroleptic are described. A. Three patients showed a marked increase in the psychopathology during neuroleptic treatment. These episodes were treated by decreasing or discontinuing the neuroleptics. They did not respond to anticholinergic durgs nor did they respond to an increase in dosage, (another side effect previously reported and referred to here) indeed this treatment worsened the situation. B. Ten patients showed a mixed picture of catatonic excitement or inhibition on neuroleptics and several developed hallucinatory episodes. All of these exacerbations were terminated by anticholinergic injections. Other more familiar CNS abnormalities produced by neuroleptics are briefly discussed.