Electroconvulsive Therapy in the Management of Neuroleptic Malignant Syndrome: A Case Report

Authors : Beyazit Garip, Burcu Buzkan, Denise Öykü İnanç
Pages : 1310-1315
Doi:10.54005/geneltip.1622637
View : 45 | Download : 125
Publication Date : 2025-12-31
Article Type : Other Papers
Abstract :Aim: Neuroleptic Malignant Syndrome (NMS) is a rare but potentially life-threatening reaction to antipsychotic treatment. This syndrome is characterized by symptoms such as hyperthermia, altered mental status, autonomic dysregulation, and generalized muscle rigidity. NMS is believed to result from a disruption in the dopaminergic system within the central nervous system. Methods: A 29-year-old woman with a history of psychotic disorder was admitted to the intensive care unit (ICU) with a diagnosis of Neuroleptic Malignant Syndrome (NMS). She had recently been initiated on paliperidone palmitate, a long-acting injectable antipsychotic, for the management of an acute psychotic exacerbation. Loading doses were administered on days 1 and 8. Within one week of the second dose, the patient developed high-grade fever, tachycardia, generalized muscle rigidity, confusion, and a marked elevation in serum creatine phosphokinase levels, prompting transfer to the ICU for intensive monitoring and supportive management. Bilateral electroconvulsive therapy (ECT) was initiated following standard safety protocols, with sessions scheduled three times per week. Results: Progressive improvement in the patient’s overall clinical status and swallowing function, accompanied by a reduction in upper extremity rigidity, was observed beginning with the second session of ECT. In addition, a marked and rapid enhancement of autonomic functions was noted over the course of treatment. A total of ten ECT sessions were administered, resulting in substantial and clinically significant therapeutic benefits. Conclusions: This case presentation highlights the role of ECT in managing NMS caused by long-acting antipsychotic treatment. Additionally, it underscores the complications that may arise during the treatment period and emphasizes that early intervention can be both life-saving and effective.
Keywords : EKT, NMS, şizofreni, uzun etkili antipsikotikler.

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