Addition of carbamazepine to long-term treatment with neuroleptics may induce neuroleptic malignant syndrome

Background: Carbamazepine is an anticonvulsant, but also has an anti-manic effect, and recently it has been increasingly used in combination with neuroleptics. Nevertheless, there have been very few reports on the involvement of carbamazepine in the occurrence of neuroleptic malignant syndrome (NMS). Methods: A case of NMS occurring after addition of carbamazepine to long-term neuroleptic administration is described. Results: The patient had been treated with neuroleptics for about 30 years, and NMS developed when carbamazepine (400 mg/day) was added. Conclusions: This case suggests that clinicians should consider the risk of NMS when carbamazepine is administered to patients undergoing long-term treatment with neuroleptics.