Biomaterial Database

Psychosis associated with clonazepam therapy for blepharospasm. 1982

M C White, and J J Silverman, and J W Harbison

A 73-year-old woman with no previous psychiatric history received clonazepam maintenance therapy for essential blepharospasm. Visual, auditory, and tactile hallucinations as well as paranoid delusions were documented. Dose reduction resulted in complete disappearance of the hallucinations and reduction of paranoia to an acceptable level, with no exacerbation during the subsequent 12 months. To our knowledge, this is the first well documented report of psychosis induced by clonazepam. Psychosis was probably related to clonazepam-induced increased central nervous system serotonin and possible predisposition to organic brain syndrome by undocumented causes. Dose reduction is suggested as an alternative to discontinuing the drug when hallucinations or paranoia arise during clonazepam therapy, if no other satisfactory treatment is available and if adequate patient monitoring and protection exist.

UI	MeSH Term	Description	Entries
D010259	Paranoid Disorders	Chronic mental disorders in which there has been an insidious development of a permanent and unshakeable delusional system (persecutory delusions or delusions of jealousy), accompanied by preservation of clear and orderly thinking. Emotional responses and behavior are consistent with the delusional state.	Paranoia,Paranoid Psychoses,Psychoses, Paranoid,Disorder, Paranoid,Disorders, Paranoid,Paranoias,Paranoid Disorder
D011605	Psychoses, Substance-Induced	Psychotic organic mental disorders resulting from the toxic effect of drugs and chemicals or other harmful substance.	Psychoses, Drug,Psychoses, Toxic,Substance-Induced Psychoses,Toxic Psychoses,Drug Psychoses,Psychoses, Substance Induced,Substance Induced Psychoses
D001764	Blepharospasm	Excessive winking; tonic or clonic spasm of the orbicularis oculi muscle.	Blepharospasms
D002998	Clonazepam	An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of GAMMA-AMINOBUTYRIC ACID receptor responses.	2H-1,4-Benzodiazepin-2-one, 5-(2-chlorophenyl)-1,3-dihydro-7-nitro-,Klonopin,Antelepsin,Rivotril,Ro 5-4023,Ro 54023
D003702	Delusions	A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates.	Delusion
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005141	Eyelid Diseases	Diseases involving the EYELIDS.	Disease, Eyelid,Diseases, Eyelid,Eyelid Disease
D005260	Female		Females
D006212	Hallucinations	Subjectively experienced sensations in the absence of an appropriate stimulus, but which are regarded by the individual as real. They may be of organic origin or associated with MENTAL DISORDERS.	Hallucination of Body Sensation,Hallucinations, Auditory,Hallucinations, Dissociative,Hallucinations, Elementary,Hallucinations, Formed, of People,Hallucinations, Gustatory,Hallucinations, Hypnagogic,Hallucinations, Hypnapompic,Hallucinations, Internal Body Sensation,Hallucinations, Kinesthetic,Hallucinations, Mood Congruent,Hallucinations, Mood Incongruent,Hallucinations, Olfactory,Hallucinations, Organic,Hallucinations, Reflex,Hallucinations, Sensory,Hallucinations, Somatic,Hallucinations, Tactile,Hallucinations, Verbal Auditory,Hallucinations, Visual,Hallucinations, Visual, Formed,Hallucinations, Visual, Unformed,Auditory Hallucination,Auditory Hallucination, Verbal,Auditory Hallucinations,Auditory Hallucinations, Verbal,Body Sensation Hallucination,Body Sensation Hallucinations,Dissociative Hallucination,Dissociative Hallucinations,Elementary Hallucination,Elementary Hallucinations,Gustatory Hallucination,Gustatory Hallucinations,Hallucination,Hallucination, Auditory,Hallucination, Dissociative,Hallucination, Elementary,Hallucination, Gustatory,Hallucination, Hypnagogic,Hallucination, Hypnapompic,Hallucination, Kinesthetic,Hallucination, Mood Congruent,Hallucination, Mood Incongruent,Hallucination, Olfactory,Hallucination, Organic,Hallucination, Reflex,Hallucination, Sensory,Hallucination, Somatic,Hallucination, Tactile,Hallucination, Verbal Auditory,Hallucination, Visual,Hypnagogic Hallucination,Hypnagogic Hallucinations,Hypnapompic Hallucination,Hypnapompic Hallucinations,Kinesthetic Hallucination,Kinesthetic Hallucinations,Mood Congruent Hallucination,Mood Congruent Hallucinations,Mood Incongruent Hallucination,Mood Incongruent Hallucinations,Olfactory Hallucination,Olfactory Hallucinations,Organic Hallucination,Organic Hallucinations,Reflex Hallucination,Reflex Hallucinations,Sensory Hallucination,Sensory Hallucinations,Somatic Hallucination,Somatic Hallucinations,Tactile Hallucination,Tactile Hallucinations,Verbal Auditory Hallucination,Verbal Auditory Hallucinations,Visual Hallucination,Visual Hallucinations
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man