EPA-0875 – A Case of Benzodiazepine Withdrawal Induced Catatonia in a 73 Year Old Woman Recently Diagnosed with Dementia

Abstract

Introduction:

Catatonia is a neuropsychiatric syndrome characterized mainly by motor disturbances, known to be caused by a variety of psychiatric, medical, neurological and toxic conditions.

Objective:

There have been few cases reported in the literature of catatonia due to benzodiazepine withdrawal, with predominance in elderly population. Here we report the case of an elderly woman with initial symptoms of dementia and abuse of lorazepam, who showed catatonic symptoms after a sudden reduction of her habitual daily dose during hospitalization.

Method:

A 73 year old woman with a history of depression and recently onset of cognitive impairment compatible with dementia, was admitted at the psychiatry ward after the worsening of the behavioural disturbances. The patient had been a regular user of lorazepam for more than 10 years, which was maintained at the same dose. After two days she abruptly presented symptoms of inhibited catatonia. A family member reported on further enquiries a suspicion of abuse of lorazepam treatment.

Results:

After administration of intravenous Diazepam, a dramatic recovery was observed, and sustained improvement was achieved after an increment of the habitual lorazepam dose. Psychiatric and medical conditions were ruled-out during follow-up, and diagnosis of dementia of Alzheimer type was made after further assessments.

Conclusions:

Benzodiazepine withdrawal is not an often, but still important cause of catatonia. Older patients are at special risk, as the increased probability of being hospitalized exposes them to sudden suspension or reduction of their habitual treatment. Nevertheless, aged related vulnerability to catatonia has not been well studied yet.