Cholinergic syndrome following anticholinergic withdrawal in a schizophrenic patient abusing marijuana.
A 27-year-old neuroleptic-stabilised schizophrenic patient presented with a three-day history of psychomotor retardation, disturbed sleep, and social and emotional withdrawal following reduction of his anticholinergic dosage; his symptoms had intensified after an increase in neuroleptic dosage, based on a diagnosis of psychotic decompensation. Recognition of a cholinergic syndrome and institution of appropriate anticholinergic treatment resulted in rapid improvement. The clinical distinction between a cholinergic overdrive state and schizophrenic exacerbation, while sometimes difficult, can be critical in selecting appropriate management.
Tandon
R
R
Schizophrenia Program, University of Michigan Medical Center, Ann Arbor 48109-0120.
Dutchak
D
D
Greden
J F
JF
D000328:Adult; D001590:Benztropine / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects; D006801:Humans; D007099:Imipramine / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D011950:Receptors, Cholinergic / Q000187:drug effects*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D019966:Substance-Related Disorders / Q000209:etiology; D013577:Syndrome; D013888:Thiothixene / Q000009:adverse effects* / Q000627:therapeutic use; D014326:Tropanes / Q000009:adverse effects*
D011950:Receptors, Cholinergic; D014326:Tropanes; D001590:Benztropine; D013888:Thiothixene; D007099:Imipramine