Biomaterial Database

Clozapine-withdrawal catatonia. 2010

Mitali Wadekar, and Saba Syed

Dept. of Psychiatry and Biobehavioral Sciences, UCLA, UCLA-Psychiatry Residency Program Education Office (116A3), 16111 Plummer St., Bldg. 10, North Hills, CA 91343, USA. mitaliwadekar@gmail.com

BACKGROUND Case reports in which abrupt clozapine discontinuation led to a return of psychosis, autonomic instability, or catatonia have been previously presented in the literature. OBJECTIVE The authors report on symptom presentation and resolution in a case of abrupt withdrawal of clozapine medication. METHODS 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. RESULTS Symptoms of catatonia and autonomic instability resolved by Day 4 of treatment. CONCLUSIONS Patients and their caregivers need to be educated about the effects of abrupt cessation of clozapine administration.

UI	MeSH Term	Description	Entries
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D002389	Catatonia	A neuropsychiatric disorder characterized by one or more of the following essential features: immobility, mutism, negativism (active or passive refusal to follow commands), mannerisms, stereotypies, posturing, grimacing, excitement, echolalia, echopraxia, muscular rigidity, and stupor; sometimes punctuated by sudden violent outbursts, panic, or hallucinations. This condition may be associated with psychiatric illnesses (e.g., SCHIZOPHRENIA; MOOD DISORDERS) or organic disorders (NEUROLEPTIC MALIGNANT SYNDROME; ENCEPHALITIS, etc.). (From DSM-IV, 4th ed, 1994; APA, Thesaurus of Psychological Index Terms, 1994)	Catatonia, Malignant,Catatonia, Organic,Lethal Catatonia,Organic Catatonic Disorder,Schizophreniform Catatonia,Catatonia, Lethal,Catatonia, Schizophreniform,Catatonias,Catatonias, Lethal,Catatonias, Malignant,Catatonias, Organic,Catatonias, Schizophreniform,Catatonic Disorder, Organic,Catatonic Disorders, Organic,Lethal Catatonias,Malignant Catatonia,Malignant Catatonias,Organic Catatonia,Organic Catatonias,Organic Catatonic Disorders,Schizophreniform Catatonias
D003024	Clozapine	A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent.	Clozaril,Leponex
D005260	Female		Females
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012559	Schizophrenia	A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior.	Dementia Praecox,Schizophrenic Disorders,Disorder, Schizophrenic,Disorders, Schizophrenic,Schizophrenias,Schizophrenic Disorder
D012565	Schizophrenic Psychology	Study of mental processes and behavior of schizophrenics.	Psychology, Schizophrenic
D013375	Substance Withdrawal Syndrome	Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.	Drug Withdrawal Symptoms,Withdrawal Symptoms,Drug Withdrawal Symptom,Substance Withdrawal Syndromes,Symptom, Drug Withdrawal,Symptom, Withdrawal,Symptoms, Drug Withdrawal,Symptoms, Withdrawal,Syndrome, Substance Withdrawal,Syndromes, Substance Withdrawal,Withdrawal Symptom,Withdrawal Symptom, Drug,Withdrawal Symptoms, Drug,Withdrawal Syndrome, Substance,Withdrawal Syndromes, Substance
D013406	Suicide, Attempted	The unsuccessful attempt to kill oneself.	Parasuicide,Suicide Attempt,Attempt, Suicide,Attempted Suicide,Parasuicides