Clozapine Withdrawal Catatonia Research Articles

Clozapine Withdrawal Catatonia: A Case Series and Review of Literature

Background: Catatonia has been reported with withdrawal of medications. Among the various psychotropics, clozapine has been implicated to cause catatonia when abruptly withdrawn. The data regarding clozapine withdrawal catatonia are scarce and are mostly available in the form of case reports and series. Aim: In this case series, we present three cases of clozapine withdrawal catatonia and review the available literature on clozapine withdrawal clozapine. Results: All the three patients developed catatonia within 48 h to 14 days of stoppage of clozapine in the doses of 100–350 mg/day. Two of the patients experiencing clozapine withdrawal improved with reinstitution of clozapine in the previous doses along with benzodiazepines. However, one patient additionally required electroconvulsive therapy (ECT) for the management of withdrawal catatonia. A review of literature showed that clozapine withdrawal catatonia has male preponderance and has been reported with withdrawal of clozapine doses of 50–550 mg/day. The catatonia usually starts in 48 h to 2 weeks of stopping clozapine. Available literature suggests that most of the patients have been managed with restarting of clozapine, along with lorazepam and occasional patients require ECT. Conclusions: To conclude our case series and the available review of literature suggests that sudden discontinuation of clozapine can lead to withdrawal catatonia. Our cases also highlight the importance of reviewing treatment history, especially of abrupt discontinuation of clozapine when a patient on clozapine present with catatonia. This can be very helpful in deciding about further management.

Clozapine withdrawal catatonia: A case report.

Clozapine withdrawal catatonia: A case report.

Clozapine withdrawal catatonia in a young schizophrenic man

Clozapine withdrawal catatonia in a young schizophrenic man

Severe Relapsing Clozapine-Withdrawal Catatonia.

Catatonia as a clozapine-withdrawal syndrome has only been documented in the medical literature as case reports. We are reporting a case in which a 32-year-old man develops a catatonic state upon withdrawal of clozapine. The state was quite severe and needed ICU admission. The course was chronic and intermittent which we think was caused by the poor adherence to antipsychotics. The importance of identifying such cases early is underlined.

Clozapine Withdrawal Catatonia Refractory to ECT: A Case Report

Although catatonia is defined as a subtype of schizophrenia it may occur due to various medical conditions. Catatonic states associated with clozapine withdrawal have been described in a few cases. In this case report, a 46 year old man admitted to hospital in a catatonic state five days after discontinuing clozapine is presented. The patient has been diagnosed with residual schizophrenia for 30 years and he has been well maintained on clozapine for 10 years. The catatonia did not respond to ECT after 11 sessions but improved rapidly with the administration of clozapine. Catatonic states due to other etiological causes may present diagnostic and therapeutic difficulties in patients with schizophrenia. The importance of identifying such clinical conditions is underlined.

Possible Paliperidone-Induced Neuroleptic Malignant Syndrome: A Case Report

Possible Paliperidone-Induced Neuroleptic Malignant Syndrome: A Case Report

Meningoencephalitis or clozapine withdrawal catatonia or both in a patient with schizophrenia

Meningoencephalitis or clozapine withdrawal catatonia or both in a patient with schizophrenia

Clozapine-Withdrawal Catatonia

Case reports in which abrupt clozapine discontinuation led to a return of psychosis, autonomic instability, or catatonia have been previously presented in the literature. The authors report on symptom presentation and resolution in a case of abrupt withdrawal of clozapine medication. The authors describe the condition and history of the patient, a 49-year-old woman with schizophrenia, the medical support she received, and the re-initiation of her clozapine medication. Symptoms of catatonia and autonomic instability resolved by Day 4 of treatment. Patients and their caregivers need to be educated about the effects of abrupt cessation of clozapine administration.

Clozapine Withdrawal Catatonia Associated With Cholinergic and Serotonergic Rebound Hyperactivity

Catatonia as a clozapine withdrawal syndrome has not been well documented. There is only 1 case of excited catatonia described with the diagnosis made according to strict criteria. The authors report a patient who developed a catatonic stuporous state following abrupt discontinuation of clozapine, associated with features of cholinergic and serotonergic hyperactivity. The catatonic state resolved within 1 week with reinstatement of clozapine. It is suggested that serotonergic hyperactivity was involved, contributed by cholinergic rebound, in the pathogenesis of this patient's clozapine withdrawal catatonic syndrome.

Clozapine Withdrawal Catatonia and Neuroleptic Malignant Syndrome: a Case Report

Clozapine Withdrawal Catatonia and Neuroleptic Malignant Syndrome: a Case Report