Alonso Elías Garrido-Pinzás , Marcelo Cruzalegui , Cynthia Cabrejos Novoa
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Abrupt clozapine discontinuation can trigger a rare withdrawal syndrome characterized by psychosis, serotonergic symptoms, catatonia, and cholinergic rebound symptoms.
Case presentation
We report a 37-year-old woman with schizoaffective disorder who accidentally stopped clozapine abruptly, leading to severe psychomotor agitation, psychosis, catatonia, and dysautonomia, requiring hospitalization. Differential diagnoses, including neuroleptic malignant syndrome, were considered. Symptoms gradually improved upon reintroducing clozapine, confirming the diagnosis of clozapine withdrawal syndrome.
Discussion
Clozapine withdrawal syndrome may be underdiagnosed. The most effective treatment is to restart clozapine; gradual tapering is preferred to avoid complications when discontinuation is necessary.
Conclusion
Awareness of clozapine withdrawal is crucial for early diagnosis and treatment.
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