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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 ,
Denise Dutchak  and
John F. Greden
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
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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
Information
The British Journal of Psychiatry , Volume 154 , Issue 5 , May 1989 , pp. 712 - 714
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

Andreasen, N. C. (1982) Negative symptoms in schizophrenia: definition and reliability. Archives of General Psychiatry, 39, 784–788.Google Scholar
Crow, T. J. (1980a) Positive and negative schizophrenic symptoms and the role of dopamine. British Journal of Psychiatry, 137, 383–386.Google Scholar
Crow, T. J. (1980b) Molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 1–9.Google Scholar
Dilsaver, S. C., Kronfol, Z., Sackellares, J. C., et al (1984a) Antidepressant withdrawal syndromes: evidence supporting the cholinergic overdrive hypothesis. Journal of Clinical Psychopharmacology, 3, 157–164.Google Scholar
Dilsaver, S. C., Leckrone, J. & Greden, J. F. (1984b) Cholinergic syndrome from psychotropic withdrawal in a marijuana abuser. Psychosomatics, 25, 632–634.CrossRefGoogle Scholar
El-Yousef, M. K., Janowsky, D. S., Davis, J. M., et al (1973) Induction of severe depression by physostigmine in marijuana intoxicated individuals. British Journal of Addiction, 68, 321–325.Google ScholarPubMed
Gardos, G., Cole, J. O. & Tarsy, D. (1978) Withdrawal syndromes associated with antipsychotic drugs. American Journal of Psychiatry, 135, 1321–1324.Google Scholar
Greden, J. F., Tandon, R. & Haskett, R. F. (1987) Physostigimine-induced cholinergic excess: a proposed model for negative schizophrenic symptoms. Scientific Abstracts, American College of Neuropharmacology, San Juan, Puerto Rico. Google Scholar
Rifkin, A., Quitkin, F. & Klein, D. (1975) Akinesia: a poorly recognized extrapyramidal behavioral disorder. Archives of General Psychiatry, 32, 672–674.CrossRefGoogle Scholar
Tandon, R. & Greden, J. F. (1987) Trihexiphenidyl treatment of negative schizophrenic symptoms. Acta Psychiatrica Scandinavica, 76, 732.Google Scholar
Tandon, R., Greden, J. F. & Silk, K. R. (1988) Treatment of negative schizophrenic symptoms with trihexiphenidyl. Journal of Clinical Psychopharmacology, 8, 212–215.Google Scholar
Treffert, D. A. (1978) Marijuana use in schizophrenia: a clear hazard. American Journal of Psychiatry, 135, 1213–1215.Google Scholar
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