title: [Catatonic dilemma in a schizoaffective patient with combined lithium-risperidone administration].
abstract: OBJECTIVE
  The case of a schizoaffective patient suffering from a malignant catatonic syndrome following combined lithium-risperidone therapy is explored.
  
  
  METHODS
  A case report and relevant deliberations regarding pathophysiology of the catatonic dilemma are discussed.
  
  
  CONCLUSIONS
  There are two critical transitions in the development of a malignant catatonic syndrome. Dopaminergic system and psychopharmacological factors are supposed to play a key role. However, other neurotransmitter systems and the individual predisposition must be considered.
authors.affiliation: Psychiatrische Universitätsklinik Zürich, Klinik für Affektive Erkrankungen und Allgemeinpsychiatrie ZH Ost, Lenggstrasse 31, Postfach 1931, 8032 Zürich, Schweiz. Rainer.Kraehenmann@puk.zh.ch
authors.forename: Rainer
authors.initials: R
authors.lastname: Krähenmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Küchenhoff
authors.forename: Heinz
authors.initials: H
authors.lastname: Böker
authors.forename: Matthis
authors.initials: M
authors.lastname: Schick
mesh_terms: D018692:Antimanic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002389:Catatonia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D003024:Clozapine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004298:Dopamine / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D016651:Lithium Carbonate / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D008134:Long-Term Care; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy*; D018967:Risperidone / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D012701:Serotonin / Q000378:metabolism
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D016651:Lithium Carbonate; D012701:Serotonin; D003024:Clozapine; D018967:Risperidone; D008140:Lorazepam; D004298:Dopamine