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Recognition and Treatment Challenges of Acute Clozapine Withdrawal Syndrome: A Case Report.
Metropulos, Jared T; Goldstein, Benjamin R; Hodapp, Benjamin.
Afiliación
  • Metropulos JT; Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA.
  • Goldstein BR; Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA.
  • Hodapp B; Psychiatry, Wisconsin Department of Health Services, Oshkosh, USA.
Cureus ; 14(6): e25765, 2022 Jun.
Article en En | MEDLINE | ID: mdl-35812573
The limited psychiatric bedspace due to the COVID-19 pandemic and the lack of access to an up-to-date medication regimen delayed the recognition of the diagnosis and treatment for a 40-year-old man with schizoaffective disorder, bipolar type, who traveled from his home city and abruptly discontinued his prescription of clozapine. He developed a cholinergic rebound syndrome including delirium and extrapyramidal symptoms (EPS). The delay included time spent in two different medical hospitals: one awaiting psychiatric bedspace, and secondly, when the patient's cholinergic rebound syndrome was misdiagnosed as acute alcohol withdrawal. Once the etiology was recognized, he was promptly treated with anticholinergic medication (benztropine) and retitrated to his outpatient dose of clozapine leading to the resolution of symptoms including delirium and EPS. This case will discuss the challenges of continuity of care in delirious, psychotic, or otherwise confused patients, including contributions from the COVID-19 pandemic. A medication card or other improvements in medication databases that may reduce delays in treatment are discussed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos