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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This is dependent on the severity of the condition.

If the full blown condition is present (fever, rigidity, autonomic instability, altered consciousness) then:

  • treatment is with immediate cessation of neuroleptics, rehydration, and correction of fever and acidosis
  • during an episode the use of electroconvulsive therapy and benzodiazepines are considered to be safe
  • rechallenge with neuroleptics is probably safe if a gap of 2 weeks has been left between resolution of the neuroleptic syndrome and the reintroduction of the drug
  • use of dantrolene and bromocriptine is unproven

In mild or early cases then management is more controversial:

  • withdrawal of neuroleptics may delay resolution or worsen the psychosis, and withdrawing them from every patient with fever and rigidity would be questionable

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