Benzodiazepine Withdrawal - Induced Catatonia

Benzodiazepines are considered to be the most effective treatment in patients suffering from an acute catatonic syndrome [5]. Especially lorazepam has been proven to alleviate psychomotor retardation and mutism [4]. The positive effects of benzodiazepines in catatonic patients are reported to be fully reversed by benzodiazepine receptor antagonists [6]. While there is sufficient evidence supporting the efficacy of benzodiazepines in acute catatonia, only few cases with catatonic symptoms due to abrupt benzodiazepine withdrawal have been reported. Two of these patients developed catatonia after discontinuing treatment with several psychopharmacological agents, benzodiazepines being one of them [1] [2]. Rosebush and Mazurek , however, reported four elderly patients with catatonia after withdrawal of benzodiazepines, the only substance previously given [3]. We report the case of a middle-aged patient suffering from a clear catatonic syndrome after withdrawal of benzodiazepines.

References

• 1 Carroll B T. Catatonia due to mixed sedative withdrawal.  J Neuropsychiatry Clin Neurosci. 1997;  9 303-304
• 2 Glover S G, Escalona R, Bishop J, Saldivia A. Catatonia associated with lorazepam withdrawal.  Psychosomatics. 1997;  38 148-150
• 3 Rosebush P I, Mazurek M F. Catatonia after benzodiazepine withdrawal.  J Clin Psychopharmacol. 1996;  16 315-319
• 4 Schmider J, Standhardt H, Deuschle M, Drancoli J, Heuser I. A double-blind comparison of lorazepam and oxazepam in psychomotor retardation and mutism.  Biol Psychiatry. 1999;  46 437-441
• 5 Ungvari G S, Leung C M, Wong M K, Lau J. Benzodiazepines in the treatment of catatonic syndromes.  Acta Psychiatr Scand. 1994;  89 285-288
• 6 Wetzel H, Heuser I, Benkert O. Stupor and affective state: alleviation of psychomotor disturbances by lorazepam and recurrence of symptoms after Ro 15- 1788.  J Nerv Ment Dis. 1987;  175 240-242