**Question:** Treatment of malignant neuroleptic syndrome include all except:

A. Withdrawal of antipsychotics
B. Increase in antipsychotic dose
C. Fluids and electrolytes management
D. Intravenous fluids and dopamine agonists

**Core Concept:** Malignant neuroleptic syndrome (MNS) is a rare but life-threatening complication of chronic use of high-potency antipsychotic medications, particularly typical antipsychotics. It is characterized by fever, tachycardia, hyperpyrexia, autonomic instability, and severe muscle rigidity. MNS is a clinical entity, not a diagnosis.

**Why the Correct Answer is Right:**

The correct answer (D) highlights the incorrect steps in treating MNS. Withdrawal of antipsychotics is the mainstay of treatment for MNS, as it is a consequence of antipsychotic overstimulation of dopamine D2 receptors. Increasing the dose of antipsychotics would worsen the condition by exacerbating the dopamine overstimulation.

**Why Each Wrong Option is Incorrect:**

A. **Withdrawal of antipsychotics**: This is the wrong option as it emphasizes the cause of MNS, not the treatment.
B. **Increase in antipsychotic dose**: Similar to option A, increasing the antipsychotic dose would worsen the condition.
C. **Fluids and electrolytes management**: While managing fluids and electrolytes is important in treating MNS, it is not the primary intervention for the condition itself.

**Clinical Pearl:** When treating MNS, the focus should be on rapid withdrawal of antipsychotics and supportive care to manage the symptoms while the body adjusts to the reduction in dopamine D2 receptor stimulation.

**Correct Answer:** D. Withdrawal of antipsychotics.