Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via Google Scholar Articles by Brown, M. Articles by Freeman, S. Search for Related Content PubMed Citation Articles by Brown, M. Articles by Freeman, S. Atypical Neuroleptics Other Neuropsychiatric Disorders Other Neuroscience

Clonazepam Withdrawal-Induced Catatonia

Received February 4, 2008; revised February 29, 2008; accepted March 3, 2008. From the Dept. of Psychiatry, Univ. of Arizona, Tucson, AZ and the Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, TX. Send correspondence and reprint requests to Mark Brown, M.D., Dept. of Psychiatry, Univ. of Arizona, 1501 N. Campbell Ave., P.O. Box 245002, Tucson, AZ 85724. e-mail: markbrownmd{at}gmail.com
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Catatonia is a often a complex syndrome. It has been divided into categories of simple and malignant, with the latter being a more severe form involving autonomic instability and/or fever and having a higher mortality rate. OBJECTIVE: There have been only two cases presented in the literature postulating benzodiazepine-withdrawal as a possible trigger for malignant catatonia. Here, the authors present a case of catatonia likely caused by abrupt benzodiazepine discontinuation; they also discuss neurobiological mechanisms relating to catatonia. METHOD: The authors report on a 60-year-old man with a history of depression and posttraumatic stress disorder who was brought to the emergency department with acute confusion, grimacing, stereotypy, refusal of food and water, muscle rigidity, mutism, and extreme negativism. He had recently and abruptly discontinued all psychotropic medication. RESULTS: After administration of lorazapam, the patient was re-started on clonazepam, after which there was a complete and sustained resolution of catatonic symptoms and autonomic instability. CONCLUSION: Catatonia may result from a wide variety of etiologies. Catatonia due to benzodiazepine-withdrawal is a rare but serious condition that may be difficult to distinguish from other causes of catatonia. The mechanism by which catatonia may be precipitated by benzodiazepine-withdrawal is unknown, but likely involves a rapid decrease in GABA transmission in the central nervous system.

Get information about faster international access.

Privacy Policy

Copyright © 2009 Academy of Psychosomatic Medicine. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us