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Clozapine withdrawal symptoms in a Parkinson's disease patient
Author(s) -
Zesiewicz Theresa A.,
Borra Sujatha,
Hauser Robert A.
Publication year - 2002
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10282
Subject(s) - clozapine , myoclonus , medicine , stupor , psychosis , parkinson's disease , hyperreflexia , anesthesia , psychology , disease , psychiatry , pediatrics , schizophrenia (object oriented programming) , vomiting
Abstract Abrupt clozapine withdrawal can cause rebound psychosis and severe somatic symptoms in psychiatric patients. We report on the case of an advanced Parkinson's disease patient who developed myoclonus, tremor, rigidity, hyperreflexia, and stupor after abrupt clozapine withdrawal. The patient's symptoms resolved with treatment with cyproheptadine. This clinical picture suggests serotonergic rebound as an explanation for the patient's symptoms, although other pharmacological mechanisms are possible. Clozapine should be gradually withdrawn over a period of 1 to 2 weeks when possible, and abruptly discontinued only when necessary. © 2002 Movement Disorder Society