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Clonazepam withdrawal-induced catatonia
1Dept. of Psychiatry, Univ. of Arizona, 1501 N. Campbell Ave., P.O. Box 245002, Tucson, AZ 85724, USA. markbrownmd@gmail.com
Psychosomatics
|July 2, 2009
Summary
Benzodiazepine-withdrawal can trigger malignant catatonia, a rare but serious condition. Prompt treatment with benzodiazepines like clonazepam can resolve symptoms, highlighting the importance of recognizing this cause of catatonia.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Catatonia is a complex syndrome with simple and malignant forms.
- Malignant catatonia presents with autonomic instability and fever, carrying a higher mortality risk.
Observation:
- A 60-year-old male with depression and PTSD presented with acute confusion, rigidity, mutism, and negativism.
- The patient had recently and abruptly discontinued all psychotropic medications.
Findings:
- The patient's catatonic symptoms and autonomic instability resolved completely after lorazepam administration and restarting clonazepam.
- This case suggests benzodiazepine discontinuation as a potential trigger for malignant catatonia.
Implications:
- Catatonia can arise from diverse causes, including benzodiazepine withdrawal.
- Understanding the neurobiological mechanisms, potentially involving GABA transmission, is crucial for diagnosing and treating this rare condition.
- Early recognition and appropriate benzodiazepine treatment are vital for managing catatonia secondary to benzodiazepine withdrawal.
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