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Cholinergic Syndrome following Anticholinergic Withdrawal in a Schizophrenic Patient Abusing Marijuana

Published online by Cambridge University Press:  02 January 2018

Rajiv Tandon*
Affiliation:
Schizophrenia Program
John F. Greden
Affiliation:
University of Michigan Medical Center
*
UH-9C-9150, University of Michigan Medical Center, Ann Arbor, MI 48109-0120, USA

Abstract

A 27-year-old neuroleptic-stabilised schizophrenic patient presented with a three-day history of psychomotor retardation, disturbed sleep, and social and emotional withdrawal following reduction of his anticholinergic dosage; his symptoms had intensified after an increase in neuroleptic dosage, based on a diagnosis of psychotic decompensation. Recognition of a cholinergic syndrome and institution of appropriate anticholinergic treatment resulted in rapid improvement. The clinical distinction between a cholinergic overdrive state and schizophrenic exacerbation, while sometimes difficult, can be critical in selecting appropriate management.

Type
Brief Reports
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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