Successful treatment of hydroxyzine and dexclorfeniramine maleate in combination with electroconvulsive therapy in a neuroleptic malignant catatonia: a case report.

Malign neuroleptic syndrome is a potentially life-threatening condition that is normally treated with electroconvulsive therapy (ECT). In this case report, we discuss a severely agitated and catatonic bipolar I patient who developed a neuroleptic malignant syndrome and did not improve with benzodiazepines and ECT. On the basis of anecdotal reports of the positive effects of antihistamines in psychosis and ECT, we treated our case with a combination of two antihistamines, hydroxyzine and dexclorfeniramine maleate, and ECT, which improved the clinical picture to the point of clinical remission.