Thioridazine withdrawal-induced behavioral deterioration treated with clonidine: two case reports.
Neuroleptic withdrawal reactions have significant clinical and medicolegal implications for individuals with developmental disabilities. Behavioral deterioration following neuroleptic taper can represent (a) relapse of a mental illness, (b) and anticholinergic rebound reaction, (c) tardive akathisia, and (d) possibly a supersensitivity psychosis. Such reactions may preclude the discontinuation of neuroleptic drug therapy, even in the absence of a drug-responsive psychiatric illness. In this report, the case histories of two individuals who experienced a thioridazine (Mellaril) withdrawal-induced behavioral deterioration were presented. Both reactions were characterized by anxiety and insomnia, and the patients' symptoms were relieved by uncontrolled treatment with clonidine (Catapres) therapy. Evidence for adrenergic hyperactivity as a mediating event was presented.
Sovner
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Habilitative Psychiatry Service, (Department of Psychiatry), New England Medical Center, Boston, MA 02111, USA.
D000279:Administration, Cutaneous; D001008:Anxiety Disorders / Q000139:chemically induced* / Q000188:drug therapy / Q000523:psychology; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D003000:Clonidine / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced* / Q000188:drug therapy / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000523:psychology; D013881:Thioridazine / Q000008:administration & dosage / Q000009:adverse effects*
D003000:Clonidine; D013881:Thioridazine