Status Cataplecticus Induced by an Abrupt Duloxetine Withdrawal-A Case Report.

IF 0.8 4区 医学 Q4 CLINICAL NEUROLOGY Clinical Neuropharmacology Pub Date : 2023-09-01 Epub Date: 2023-07-18 DOI:10.1097/WNF.0000000000000563
Marek Cierny, John Feemster, Mohsin Hamid, Humberto A Battistini
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Abstract

Abstract: In persons with narcolepsy type 1, sudden withdrawal of antidepressants can cause status cataplecticus. We describe a 77-year-old female patient with long-standing history of narcolepsy type 1 complaining of recurrent short sudden episodes of whole-body paralysis, with preserved consciousness and memory. Episodes started an hour after her family invited her to celebrate Mother's Day. One week prior, patient had abruptly discontinued duloxetine. Cataplectic episodes resolved within 24 hours after resumption of duloxetine and treatment of hypokalemia. Status cataplecticus has been reported after withdrawal of venlafaxine, fluoxetine, and clomipramine. This is the first report of status cataplecticus due to duloxetine withdrawal. We review the pathophysiology of antidepressant withdrawal-induced status cataplecticus. In persons with narcolepsy type 1, physicians discontinuing any antidepressant should counsel on adverse effects of antidepressant withdrawal and reduce the dose in tapering manner.

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度洛西汀突然停药引起的状态性白内障——一例报告。
摘要:在1型发作性睡病患者中,突然停用抗抑郁药会导致精神紧张状态。我们描述了一名77岁的女性患者,她有长期的1型发作性睡病病史,抱怨全身瘫痪的复发性短暂突然发作,意识和记忆得以保留。剧集开始于她的家人邀请她庆祝母亲节一小时后。一周前,患者突然停用度洛西汀。恢复服用度洛西汀并治疗低钾血症后24小时内,白内障发作得到缓解。据报道,在停药文拉法辛、氟西汀和克罗米帕明后出现痉挛状态。这是第一例因度洛西汀停药而引起的昏迷状态报告。我们综述了抗抑郁药戒断状态的病理生理学。对于1型发作性睡病患者,停止服用任何抗抑郁药的医生应就停药的不良影响提出建议,并逐渐减少剂量。
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来源期刊
Clinical Neuropharmacology
Clinical Neuropharmacology 医学-临床神经学
CiteScore
1.20
自引率
10.00%
发文量
63
审稿时长
6-12 weeks
期刊介绍: Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.
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