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A Severe Neuroleptic Malignant Syndrome Treated with Daily Electroconvulsive Therapy: A Case Report

Özlem ERDEN AKİ, Ahmet GÜRCAN, Ş. Can GÜREL, M. Kâzım YAZICI
2022 33(2): 139-142
DOI: 10.5080/u26535
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İNGİLİZCE ÖZET

Neuroleptic malignant syndrome (NMS) is a rare but life-threatening
condition caused by dopamine modulating medications, particularly
antipsychotics. First-line treatments of neuroleptic malignant
syndrome are supportive care, discontinuation of the offending
agent and pharmacotherapy. In drug-resistant and severe situations,
electroconvulsive therapy (ECT) is recommended as well. In this paper
we present a 23-year old male with bipolar disorder who was treated with
multiple injections of zuclopenthixol long acting and depot forms for a
recent manic episode and developed NMS. The patient was transferred
to an intensive care unit, medical management was initiated including
benzodiazepines, bromocriptine and dantrolene. Due to the inadequate
response after several days, ECT (bitemporal electrode placement, briefpulse,
on a daily basis) was initiated. After 17 sessions, NMS relieved
and there was no need for maintenance ECT. The patient is under
follow-up care for 3 years with no cognitive and physical sequela.
Keywords: Electroconvulsive therapy, neuroleptic malignant syndrome,
bipolar disorder