[Treatment of catatonic syndrome with fluoxetine. Case report]

The case of catatonic syndrome in 34-years old male patient is described. The patient's initial complaints regarded somatic distress. Previously, because of persistence of somatic complaints and depressed mood, the patient was treated with classic antidepressants with no clinical effect. Consequently, before admission to our clinic, the patient received neuroleptic treatment without any improvement. To our clinic he was referred as drug-resistant schizoaffective psychosis. He was completely inactive, had hipochondriac delusions and blunted affect. Further on, severe psychomotor inhibition and negativism prevailed. Initial treatment with fluphenazine did not bring any clinical effect. Because of presence of depressed mood and lack of activity, fluoxetine was administered concomitantly with fluphenazine. After 8 weeks administration of fluoxetine 20 mg daily showed substantial clinical improvement, especially in regard to the patient's mood and activity. The dose of fluoxetine was increased to 40 mg daily, and the patient was discharged from the clinic. The follow-up revealed that the patient reassumed his professional career. He was still on fluoxetine 20 mg daily and showed substantial clinical improvement. His overall tolerance of fluoxetine 20-40 mg daily was very good.