Catatonia after olanzapine and alprazolam withdrawal

We report the case of a paranoid schizophrenic woman who presented a cataleptic and catatonic syndrome five days after the abrupt discontinuation of her treatment by olanzapine (Zyprexa®) and alprazolam (Xanax®), because of an emergency surgery. Catatonic symptoms included mutism, prostration, waxy flexibility, oculogyric mouvements, no swallowing and got complicated with cardiovascular and respiratory vegetative disorders. Symptoms disappeared after administration of alprazolam and haloperidol (Haldol®), rapidly replaced by risperidone (Risperdal®). For one year, catatonic troubles did not recur. Causality assessment was found in favour of a drug withdrawal, but was not helpful in incriminating one of the psychotropic drugs. This observation suggests that any psychotropic drug may induce serious withdrawal disorders, and should be reintroduced as soon as possible in the post-operative period.