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Recurrent clonazepam withdrawal delirium in a postoperative neurosurgical patient: a case report
Eric William Lutz1, Christopher Hines2
1Behavioral Health, Walter Reed National Military Medical Center, Bethesda, Maryland, USA eric.w.lutz3.mil@mail.mil.
Abstract:
We present a case of benzodiazepine withdrawal delirium in a middle-aged man undergoing spinal surgery. Benzodiazepines were stopped prior to surgery and on postoperative day 4, the patient exhibited significant paranoia, hyperarousal and ideas of reference. Patient's symptoms resolved after reintroduction of his benzodiazepines. It is important to include benzodiazepine withdrawal in the differential diagnosis for acute delirium even in those patients taking low or moderate doses. Benzodiazepine withdrawal delirium typically responds rapidly to restarting benzodiazepines. In patients with known discontinuation issues, early consultation with consult-liaison psychiatry and preoperative planning for early medication re-initiation is paramount.
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