Clozapine withdrawal catatonia associated with cholinergic and serotonergic rebound hyperactivity: a case report

Clin Neuropharmacol. 2004 Sep-Oct;27(5):216-8. doi: 10.1097/01.wnf.0000145506.99636.1b.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Catatonia / etiology
  • Catatonia / psychology*
  • Clozapine / adverse effects*
  • Humans
  • Hyperkinesis / etiology
  • Hyperkinesis / psychology*
  • Male
  • Middle Aged
  • Parasympathetic Nervous System / physiopathology*
  • Recurrence
  • Schizophrenia / complications
  • Schizophrenia / drug therapy
  • Serotonin / physiology*
  • Substance Withdrawal Syndrome / psychology*

Substances

  • Antipsychotic Agents
  • Serotonin
  • Clozapine