title: Clozapine withdrawal catatonia associated with cholinergic and serotonergic rebound hyperactivity: a case report.
abstract: Catatonia as a clozapine withdrawal syndrome has not been well documented. There is only 1 case of excited catatonia described with the diagnosis made according to strict criteria. The authors report a patient who developed a catatonic stuporous state following abrupt discontinuation of clozapine, associated with features of cholinergic and serotonergic hyperactivity. The catatonic state resolved within 1 week with reinstatement of clozapine. It is suggested that serotonergic hyperactivity was involved, contributed by cholinergic rebound, in the pathogenesis of this patient's clozapine withdrawal catatonic syndrome.
authors.affiliation: Department of General and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
authors.forename: Andrew Wei-Chiang
authors.initials: AW
authors.lastname: Yeh
authors.forename: Joseph W Y
authors.initials: JW
authors.lastname: Lee
authors.forename: Tsun-Chi
authors.initials: TC
authors.lastname: Cheng
authors.forename: Jung-Kwang
authors.initials: JK
authors.lastname: Wen
authors.forename: Wei-Hsi
authors.initials: WH
authors.lastname: Chen
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects*; D002389:Catatonia / Q000209:etiology / Q000523:psychology*; D003024:Clozapine / Q000009:adverse effects*; D006801:Humans; D006948:Hyperkinesis / Q000209:etiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D012008:Recurrence; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy; D012701:Serotonin / Q000502:physiology*; D013375:Substance Withdrawal Syndrome / Q000523:psychology*
chemical_list: D014150:Antipsychotic Agents; D012701:Serotonin; D003024:Clozapine