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Catatonia following acute dopamine depletion

Lookup NU author(s): Dr Niraj Ahuja


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Background: Several reports in the literature demonstrate that catatonia may be induced by neuroleptics, and catatonia may precede or follow the neuroleptic malignant syndrome (NMS), suggesting that catatonia might be a hypodopaminergic state. We present direct evidence in favor of this contention. Case Report: A 51-year-old female Parkinson’s disease patient developed multiple catatonic signs preceding a full-blown acute dopamine depletion syndrome (ADDS) with altered sensorium, massive extrapyramidal rigidity, hyperthermia, autonomic disturbance, and markedly elevated serum creatine phosphokinase, following planned reduction of levodopa therapy for dopa-dyskinesias. She was still recovering with restoration of levodopa dosage and addition of bromocriptine when she again developed catatonia following inadvertent reduction in her dosage. She never received any dopamine antagonists and did not receive lorazepam or ECT for treatment of catatonia. Catatonia appeared twice following withdrawal of levodopa in this case. It resolved on both occasions, along with the ADDS, following restoration of levodopa and addition of bromocriptine. Conclusions: Observations suggest that both NMS (functionally equivalent to ADDS) and catatonia are hypodopaminergic states, and that both lie on the same spectrum of disorders. Hypodopaminergia may be the fundamental neurochemical denominator in catatonia, along with secondary or consequential perturbations of other transmitter systems.

Publication metadata

Author(s): Ahuja N; Nehru R

Publication type: Article

Publication status: Published

Journal: The Journal of Neuropsychiatry and Clinical Neurosciences

Year: 2002

Volume: 14

Issue: 1

Pages: 107 abstract no. P2

ISSN (print): 0895-0172

ISSN (electronic): 1545-7222

Publisher: American Psychiatric Publishing, Inc.


Notes: ANPA ABSTRACTS - Poster Presentation Thirteenth Annual Meeting of the American Neuropsychiatric Association: 9-12 March 2002, La Jolla, California.