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To those who dispute or object to my comments about Joe's death, I'm standing pat. Given the rather vague definition of neuroleptic malignant syndrome (NMS), it doesn't matter whether his history is an exact match. The point is, NMS is a life-threatening condition that may result from mis-management of drug dosage, and something like that appears to be what happened to Joe. The PDR, from which I draw that inference, may not be the most glamorous source but it's very reliable, as every word must withstand intense scrutiny by the FDA. For those who insist on not reading it, here's what the PDR says: (p.2711): "Withdrawal Emergent Hyperpyrexia and Confusion: Four cases of a symptom complex resembling the neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, and altered consciousness), similar to that reported in association with the rapid dose reduction or withdrawal of other dopaminergic drugs, have been reported in association with the abrupt withdrawal or lowering of the dose of tolcapone. In 3 of these cases, CPK was elevated as well. One patient died, and the other 3 patients recovered over periods of approximately 2, 4, and 6 weeks." And, (p.987): "SYMMETREL should not be discontinued abruptly in patients with Parkinson's disease since a few patients have experienced a parkinsonian crisis, i.e., a sudden marked clinical deterioration, when this medication was suddenly stopped. The dose of anticholinergic drugs or of SYMMETREL should be reduced if atropine-like effects appear when these drugs are used concurrently. Neuroleptic Malignant Syndrome (NMS): Sporadic cases of possible Neuroleptic Malignant Syndrome (NMS) have been reported in association with dose reduction or withdrawal of SYMMETREL therapy. Therefore, patients should be observed carefully when the dosage of SYMMETREL is reduced abruptly or discontinued, especially if the patient is receiving neuroleptics. NMS is an uncommon but life-threatening syndrome characterized by fever or hyperthermia; neurologic findings including muscle rigidity, involuntary movements; mental status changes; other disturbaances such as autonomic dysfunction, tachycardia, tachypnea, hyper- or hypotension; laboratory findings such as creatine phosphokinase elevation, leukocytosis, myoglobinuria, and increased serum myoglobin." Quibble if you like about definition, to me the message seems clear; Ignore it at your own risk. Cheers, Joe -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013